The Effect of Thoracic Paravertebral Blockade on Intercostal Somatosensory Evoked Potentials

Richardson, Jonathan; Jones, J. G.; Atkinson, Robert

doi:10.1097/00000539-199808000-00025

Cited by 49 publications

(30 citation statements)

References 10 publications

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“…[14] Also we speculated the reason for this significant difference in HR might be explained by qualitatively greater block of the somatic nerves together with block of the sympathetic chain and the rami communicans when local anesthetic is placed alongside the vertebral column rather than anatomically distant from it in the paravertebral space. [15]…”

Section: Discussionmentioning

confidence: 99%

Single-dose paravertebral blockade versus epidural blockade for pain relief after open renal surgery: A prospective randomized study

2013

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Background:Paravertebral block (PVB) has been an established technique for providing analgesia to the chest and abdomen. We conducted the current study to compare single-dose PVB versus single-dose epidural blockade (EP) for pain relief after renal surgery.Methods:Eighty patients scheduled for renal surgery were randomly assigned into two groups according to the analgesic technique, PVB group or EP group. General anesthesia was induced for all patients. Postoperative pain was assessed over 24 h using 10-cm visual analog scale (VAS). Postoperative total pethidine consumption was recorded. Any postoperative events, such as nausea, vomiting, shivering, or respiratory complications, were recorded. Hemodynamics and blood gasometry were also recorded.Results:EP group showed significant decrease of both heart rate and mean blood pressure at most of the operative periods when compared with PVB group. There was no difference in total rescue analgesic consumption. Postoperative VAS showed no significant difference between the studied groups. Postoperative events were comparable in both the groups.Conclusion:Single injection PVB resulted in similar analgesia but greater hemodynamic stability than epidural analgesia in patients undergoing renal surgery, therefore this technique may be recommended for patients with coexisting circulatory disease.

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Section: Discussionmentioning

confidence: 99%

Single-dose paravertebral blockade versus epidural blockade for pain relief after open renal surgery: A prospective randomized study

2013

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“…4 Richardson et al 16 have demonstrated that thoracic PVB can abolish the intercostal somatosensory-evoked potentials. Liver capsule injury visceral pain was managed successfully with a continuous infusion of local anesthetic at the right T10 level through a paravertebral catheter, 17 whereas common bile duct dilation–associated pain, mediated parasympathetically through the vagus, could not be alleviated by PVB.…”

Section: Discussionmentioning

confidence: 99%

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

Chen

Zhi-pin

Yan

et al. 2014

Regional Anesthesia and Pain Medicine

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Background and ObjectivesWe hypothesized that continuous right thoracic paravertebral block, following bolus initiation, decreases opioid consumption after right-lobe hepatectomy in patients receiving patient-controlled intravenous analgesia with sufentanil.MethodsPatients undergoing right-lobe hepatectomy with a right thoracic paravertebral catheter placed at T7 30 minutes before surgery were randomly assigned to receive through this catheter either a 10-mL bolus of 0.2% ropivacaine before emergence, followed by a continuous infusion of 6 mL/h for 24 hours (PVB group), or saline at the same scheme of administration (control group). All patients were started on patient-controlled intravenous analgesia with sufentanil in the postanesthesia care unit. The primary outcome measure was total sufentanil consumption during the first 24 postoperative hours. P = 0.05 was considered as significant. For the multiple comparisons of data at 5 different time points, the P value for the 0.05 level of significance was adjusted to 0.01.ResultsSixty-six patients were assessed for eligibility, and a PVB catheter was successfully placed for 48 patients. Data were analyzed on 22 patients in group PVB and 22 patients in the control group. The cumulative sufentanil consumption in the PVB group (54.3 ± 12.1 μg) at 24 postoperative hours was more than 20% less than that of the control group (68.1 ± 9.9 μg) (P < 0.001). There was also a significant difference in pain scores (numerical rating scale) between groups, where the PVB group had lower scores than did the control group at rest and with coughing for the first 24 hours (P < 0.001).ConclusionsContinuous right thoracic paravertebral block, following bolus initiation, has an opioid-sparing effect on sufentanil patient-controlled intravenous analgesia for right-lobe hepatectomy patients and reduces numerical rating scale pain scores at rest and with coughing in the first 24 postoperative hours.

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“…[24] None of patients from the current study were referred to the pain clinic with complaints of post-mastectomy pain until 3 months after the study. However, it is not possible to comment on the likely percentage of patients who would actually benefit from these blocks and be free of chronic post-mastectomy pain.…”

Section: Discussionmentioning

confidence: 99%

Comparison of paravertebral and interpleural block in patients undergoing modified radical mastectomy

Kundra

Varadharajan

Kotteeswaran

et al. 2013

J Anaesthesiol Clin Pharmacol

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Background:Paravertebral and inter pleural blocks (IPB) reduce post-operative pain and decrease the effect of post-operative pain on lung functions after breast surgery. This study was designed to determine their effect on lung functions and post-operative pain in patients undergoing modified radical mastectomy.Materials and Methods:A total of 120 American Society of Anesthesiologists physical status 1 and 2 patients scheduled to undergo breast surgery were randomly allocated to receive IPB (Group IPB, n = 60) or paravertebral block (PVB) (Group PVB, n = 60) with 20 ml of 0.5% bupivacaine pre-operatively. A standard protocol was used to provide general anesthesia. Lung function tests, visual analog scale (VAS) for pain at rest and movement, analgesic consumption were recorded everyday post-operatively until discharge.Results:Lung functions decreased on 1st post-operative day and returned to baseline value by 4th post-operative day in both groups. VAS was similar in both groups. There was no significant difference in the consumption of opioids and diclofenac in both groups. Complete block was achieved in 48 patients (80%) in paravertebral group and 42 patients (70%) in inter pleural group.Conclusion:To conclude, lung functions are well-preserved in patients undergoing modified radical mastectomy under general anesthesia supplemented with paravertebral or IPB. IPB is as effective as PVB for post-operative pain relief. PVB has the added advantage of achieving a more complete block.

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The Effect of Thoracic Paravertebral Blockade on Intercostal Somatosensory Evoked Potentials

Cited by 49 publications

References 10 publications

Single-dose paravertebral blockade versus epidural blockade for pain relief after open renal surgery: A prospective randomized study

Single-dose paravertebral blockade versus epidural blockade for pain relief after open renal surgery: A prospective randomized study

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

Comparison of paravertebral and interpleural block in patients undergoing modified radical mastectomy

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