Paravertebral blockade

Abstract

SummaryThe failure rate and complications were studied prospectively in 367paediatric and adult patients who had received a thoracic or lumbar paravertebral block. The overall failure rate was 10.1 YO; adults 10.7%; children 6.2%. The frequency of complications were: hypotension: 4.6%; vascular puncture: 3.8%; pleural puncture: 1 . 1 %; pneumothorax: 0.5%. Since these results are similar to those found with alternative methods, e.g. epidural, intrapleural and intercostal blocks, paravertebral block can be recommended as an effective, safe technique for unilateral analgesia in both adults and children.

Paravertebral Blocks Reduce Narcotic Use Without Affecting Perfusion in Patients Undergoing Autologous Breast Reconstruction

“…PVBs are found to be relatively safe, and hypotension is rare in normovolemic patients. 27 {Naja, 2006 #74, 28,29 } However, in patients who are hypovolemic, there may be a greater risk of associated hypotension with use of regional anesthesia. 28 Hypotension and hypovolemia – factors that lead to decrease cardiac output and vasoconstriction – have been associated with adverse outcomes in free tissue transfer.…”

“…27 {Naja, 2006 #74, 28,29 } However, in patients who are hypovolemic, there may be a greater risk of associated hypotension with use of regional anesthesia. 28 Hypotension and hypovolemia – factors that lead to decrease cardiac output and vasoconstriction – have been associated with adverse outcomes in free tissue transfer. 30 , 31 Conversely, existing literature also shows that fluid overload is associated with both perioperative morbidity 32 and flap thrombosis 18 - the balance of maintaining adequate perfusion and preventing excess fluid administration is delicate.…”

Continuous Right Thoracic Paravertebral Block Following Bolus Initiation Reduced Postoperative Pain After Right-Lobe Hepatectomy

“…According to previous studies, we arbitrarily defined block success as loss of pinprick sensation in 3 or more ipsilateral vertebral dermatomes. 6 After liver resection, the possibility of extending the analgesic benefits of paravertebral analgesia beyond 24 hours with or without a more concentrated solution of local anesthetic warrants further investigation. Further larger-scale studies are required to evaluate the effect of paravertebral block for right-lobe hepatectomy on clinically important outcomes including ropivacaine plasma levels, the incidence of postoperative complications, and chronic pain syndrome.…”

“…The PVB was considered successful when subjects experienced a decreased sensation to pinprick in 3 or more adjacent dermatomes corresponding to the site of injection. 6 Subjects with a successful catheter placement and nerve block onset per protocol were retained in the study. If the desired block was not achieved, we offered the patient the choice of reinsertion of the PVB catheter or to be excluded from the study.…”

In response to: Comparison of paravertebral and interpleural block in patients undergoing modified radical mastectomy

“…Horner syndrome has also been reported with PVB. The reported incidence of complications[4] of PVB as follows: Hypotension: 4.6%; vascular puncture: 3.8%; pleural puncture: 1.1%; pneumothorax: 0.5%. Bronchospasm has been reported after interpleural analgesia also.…”