A single‐injection, multi‐segmental paravertebral block – extension of somatosensory and sympathetic block in volunteers (<sup>Note</sup>)

Saito, Toshiyuki; Den, S.; Cheema, S. P. S.; Tanuma, Kumiko; Carney, Edward; Carlsson, Christer; Richardson, Jonathan

doi:10.1034/j.1399-6576.2001.450105.x

Cited by 73 publications

(42 citation statements)

References 11 publications

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“…Kairaluoma [2] et al (2006) in his study demonstrated the longterm beneficial effects of Paravertebral Block (PVB) on postoperative pain. Similar results were demonstrated by Saito [3] et al (2001) and Terheggen M et al [4] (2002).…”

supporting

confidence: 80%

Pectoral Nerve Block Versus Thoracic Paravertebral Block– Comparison of Analgesic Efficacy for Postoperative Pain Relief in Modified Radical Mastectomy Surgeries

Annamalai¹,

Durairaj²,

R³

2017

jemds

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BACKGROUNDModified Radical Mastectomy (MRM) is the most common surgical procedure for operable breast malignancies. Postoperative pain has been severe in MRM cases and demands for pain relief are high. The technique of performing pectoral nerve block [PECS] using ultrasound guidance is increasing in popularity. We compared the postoperative analgesic profile of ultrasound-guided serratus plane block (SPB) and landmark-guided paravertebral block (PVB). MATERIALS AND METHODSThis study was done as a double blind, randomised, controlled trial among 60 subjects with breast cancer posted for elective MRM, of which 30 subjects were put in PECS block group and 30 subjects in paravertebral block group. PVB was performed under complete aseptic precaution with low resistance technique. PECS block was performed in supine position with the U/S probe directly above 1 st rib where pectoralis major and pectoralis minor muscles are located. Anaesthesia was maintained with sevoflurane 1% and O2/N20 mixture with a fraction of 50% inspired O2. Postoperative pain was recorded using the Visual Analogue Scale (VAS) every one-hour up to 4 hours post-surgery. RESULTSThe mean VAS scores were significantly lesser in the PECS group compared to the PVB group (p<0.05). The mean heart rates in PECS group were significantly lower than PVB group throughout the procedure. There was no significant difference in the intra-OP MAP between both the groups. CONCLUSIONUltrasound-guided PECS block is an alternative analgesic technique to thoracic PVB for postop pain relief in MRM patients. It gives superior analgesia and has fewer complications. BACKGROUND Breast cancer has emerged as the most common cancer in India, and 2 nd most common even in the rural area. Breast cancer accounts for 25% to 32% of all female cancers in all these cities. This implies, practically, one fourth of all female cancer cases are breast cancers. [1] Of the several therapeutic options for breast cancer, Modified Radical Mastectomy (MRM) is the most common surgical procedure for operable breast malignancies. Postoperative pain has been severe in MRM cases and demands for pain relief are high. KEYWORDS

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confidence: 80%

Pectoral Nerve Block Versus Thoracic Paravertebral Block– Comparison of Analgesic Efficacy for Postoperative Pain Relief in Modified Radical Mastectomy Surgeries

Annamalai¹,

Durairaj²,

R³

2017

jemds

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“…However, thoracic epidural anaesthesia is not the only regional anaesthetic technique for rib fractures. Thoracic paravertebral blocks are also effective in patients with rib fractures and are associated with less hypotension than thoracic epidural anaesthesia, likely due to their unilateral sympathetic blockade [6,14,16]. Because of this reduced degree of sympatholysis, thoracic paravertebral blocks may be preferable to thoracic epidural anaesthesia in patients at risk for heart block.…”

Section: Discussionmentioning

confidence: 95%

Development of third-degree heart block due to thoracic epidural anaesthesia

McHugh

Ibinson

2012

Injury Extra

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“…The pain signals of renal origin travel through afferent Aδ and C sympathetic fibers on the adventitia of the renal arteries, reaching the renal and intermesenteric plexus, then pass through the lowest splanchnic nerve, to enter the spinal cord via T11 -L2 dorsal roots and finally relay on the medial medullary reticular formation [23].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Nephrolithotomy under Thoracic Paravertebral Block: A Preliminary Report

Ahmed¹,

Hetta²,

Abdelraouf³

2017

J Anesth Clin Res

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A single‐injection, multi‐segmental paravertebral block – extension of somatosensory and sympathetic block in volunteers (^Note)

Abstract: One-sided extended analgesia (sensory loss) follows the paravertebral injection of lidocaine. A large ipsilateral sympathetic block is observed without change in pulse rate and with no hypotension. These are all characteristics of an optimal regional block.

Cited by 73 publications

References 11 publications

Pectoral Nerve Block Versus Thoracic Paravertebral Block– Comparison of Analgesic Efficacy for Postoperative Pain Relief in Modified Radical Mastectomy Surgeries

Pectoral Nerve Block Versus Thoracic Paravertebral Block– Comparison of Analgesic Efficacy for Postoperative Pain Relief in Modified Radical Mastectomy Surgeries

Development of third-degree heart block due to thoracic epidural anaesthesia

Percutaneous Nephrolithotomy under Thoracic Paravertebral Block: A Preliminary Report

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A single‐injection, multi‐segmental paravertebral block – extension of somatosensory and sympathetic block in volunteers (Note)

Abstract: One-sided extended analgesia (sensory loss) follows the paravertebral injection of lidocaine. A large ipsilateral sympathetic block is observed without change in pulse rate and with no hypotension. These are all characteristics of an optimal regional block.

Cited by 73 publications

References 11 publications

Pectoral Nerve Block Versus Thoracic Paravertebral Block– Comparison of Analgesic Efficacy for Postoperative Pain Relief in Modified Radical Mastectomy Surgeries

Pectoral Nerve Block Versus Thoracic Paravertebral Block– Comparison of Analgesic Efficacy for Postoperative Pain Relief in Modified Radical Mastectomy Surgeries

Development of third-degree heart block due to thoracic epidural anaesthesia

Percutaneous Nephrolithotomy under Thoracic Paravertebral Block: A Preliminary Report

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A single‐injection, multi‐segmental paravertebral block – extension of somatosensory and sympathetic block in volunteers (^Note)