Objective: Severe pain can lead to ventilatory compromise in patients with multiple rib fractures. Regional anesthetic techniques, including continuous thoracic paravertebral and thoracic epidural blocks, can be useful in reducing this pain and subsequent morbidity due to respiratory compromise. Thoracic paravertebral block can result in significant complications. Presumed epidural spread of injected medication has been described with thoracic paravertebral block. High-quality radiographic images of an attempted placement of a thoracic paravertebral catheter in the epidural space have not been reported. We present these images to highlight the occurrence of this complication.
Settings And Patients: In this case, we report an attempted placement of a thoracic paravertebral catheter that passed into the epidural space. High-fidelity, three-dimensional computer tomography images and the management of the unintended epidural catheterization are presented.
Results And Conclusions: In the setting of severe chest trauma, the potential risk of unintended placement of an intended thoracic paravertebral catheter in the epidural space is graphically illustrated as a potential risk of this procedure.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/j.1526-4637.2011.01180.x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Systematic Review and Meta-Analysis of Application of Ultrasound-Guided Thoracic Paravertebral Block in Clinical Surgical Treatment.
Ann Ital Chir
December 2024
Department of Anesthesiology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, 317000 Taizhou, Zhejiang, China.
Aim: There is a lack of consensus regarding the efficacy of thoracic paravertebral block (TPVB) and erector spinae plane block (ESPB) for postoperative pain in randomized controlled trials (RCTs). The comparison of TPVB and ESPB was explored through a systematic review and meta-analysis (MA) of relevant RCTs.
Methods: A comprehensive search of relevant literature was conducted using databases such as PubMed, Embase, and MEDLINE, from 2019 to June 2024.
Left T7 paravertebral nerve blockade activate the α7nAChR-Dependent CAP in patients undergoing thoracoscopic lobectomy: a prospective controlled study.
BMC Anesthesiol
December 2024
Department of Anesthesiology and Surgery, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, 330001, China.
Objective: This study aimed to observe the impact of Tthoracic paravertebral nerve blockade(TPVB) at left T7 level on the α7nAChR-dependent cholinergic anti-inflammatory pathway in patients undergoing thoracoscopic lobectomy.
Methods: Scheduled thoracoscopic lung surgery patients at the First Affiliated Hospital of Nanchang University from August to September 2023 were divided into two groups according to the surgical site. The experimental group underwent left T7 paravertebral nerve blockade (LTPVB group), while the control group underwent right T7 paravertebral nerve blockade (RTPVB group).
Intertransverse process block (ITPB) at the retro-superior costotransverse ligament (retro-SCTL) space: Evaluation of local anesthetic spread using MRI and sensory blockade in healthy volunteers.
J Clin Anesth
December 2024
Department of Anesthesia and Intensive Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China. Electronic address:
Background: This study evaluated the spread of a local anesthetic, using MRI and sensory blockade, after an intertransverse process block (ITPB) at the medial aspect of the retro-superior costotransverse ligament (retro-SCTL) space - the medial retro-SCTL space block.
Methods: Ten healthy volunteers received a single-injection ultrasound-guided medial retro-SCTL space block at the T4-T5 level using a mixture of 10 ml 0.5 % bupivacaine with 0.
Comparison of the Analgesic Efficacy of Erector Spinae Plane Block, Paravertebral Block and Quadratus Lumborum Block for Pelvi-ureteric Surgeries: A Randomized Double-Blind, Noninferiority Trial.
Pain Physician
December 2024
Departments of Anesthesiology, Surgical Intensive Care and, Pain Medicine, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt.
Background: Effective postoperative analgesia enhances the patient's comfort and facilitates early mobilization and recovery.
Objective: This study compared the analgesic efficacy of the erector spinae plane block (ESPB), thoracic paravertebral block (TPVB), and quadratus lumborum block (QLB) for pelvi-ureteric surgeries. The primary outcome measure in the study was the total morphine consumption during the first 48 hours following the operation.
Adding Dexmedetomidine to Methylene Blue in Thoracic Paravertebral Block for Video-Assisted Lobectomy: A Case Series Study.
Local Reg Anesth
December 2024
Department of Women, Children and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy.
Article Synopsis
- This study evaluates the effectiveness of adding dexmedetomidine (DEX) to Thoracic Paravertebral Block (TPVB) for managing postoperative pain in patients undergoing thoracic surgery.
- Six patients were monitored after receiving TPVB with ropivacaine, DEX, and methylene blue, focusing on pain levels and opioid use in the first 48 hours post-surgery.
- Results indicated that patients experienced low pain scores and reduced opioid consumption without significant side effects, suggesting DEX enhances the effectiveness of TPVB while methylene blue aids in ensuring proper anesthetic distribution.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!