Ultrasound Guidance Is Helpful for Paravertebral Block Performance and Catheter Placement in Patients with Laminectomy after Thoracotomy or Lumbotomy: A Case Series Imaging Study

Abstract

Today, the ultrasound guidance (USG) in regional anesthesia is gold standard more and more often used for medial or paramedian approaches around to the spine, such as the paravertebral (PV) block. Local anatomical changes may greatly handicap the performance of this type of block. We present clinical, sonographic, and radiological data on successful PV block and catheter placement in four patients with vertebral diseases, targeting thoracotomy or lumbotomy postoperative pain after stabilization of the involved vertebral body and preliminary arthrodesis with laminectomy by the posterior approach. We emphasize the importance of USG in this special context involving local anatomical disturbance.

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P. Pandin, S. Rettab and A. Lubansu, "Ultrasound Guidance Is Helpful for Paravertebral Block Performance and Catheter Placement in Patients with Laminectomy after Thoracotomy or Lumbotomy: A Case Series Imaging Study," Open Journal of Anesthesiology, Vol. 3 No. 2, 2013, pp. 67-73. doi: 10.4236/ojanes.2013.32018.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] G. P. Joshi, F. Bonnet, R. Shah, et al., “A Systematic Review of Randomized Trials Evaluating Regional Techniques for Postthoracotomy Analgesia,” Anesthesia & Analgesia, Vol. 107, No. 3, 2008, pp. 1026-1040. doi:10.1213/01.ane.0000333274.63501.ff
[2] R. G. Davies, P. S. Myles and J. M. Graham, “A Comparison of the Analgesic Efficacy and Side-Effects of Paravertebral vs Epidural Blockade for Thoracotomy—A Systematic Review and Meta-Analysis of Randomized Trials,” British Journal of Anesthesia, Vol. 96, No. 4, 2006, pp. 418-426. doi:10.1093/bja/ael020
[3] A. Kotzé, A. Scally and S. Howell, “Efficacy and Safety of Different Techniques of Paravertebral Block for Analgesia after Thoracotomy: A Systematic Review and Metaregression,” British Journal of Anesthesia, Vol. 103, No. 5, 2009, pp. 626- 636. doi:10.1093/bja/aep272
[4] M. J. Eason and R. Wyatt, “Paravertebral Thoracic Block —A Reappraisal,” Anaesthesia, Vol. 34, No. 7, 1979, pp. 638-642. doi:10.1111/j.1365-2044.1979.tb06363.x
[5] A. P. Boezaart, S. D. Lucas and C. E. Elliott, “Paravertebral Block: Cervical, Thoracic, Lumbar and Sacral,” Current Opinion in Anaesthesiology, Vol. 22, No. 5, 2009, pp. 637-643. doi:10.1097/ACO.0b013e32832f3277
[6] O. Riain, B. O. Donnell, T. Cuffe, et al., “Thoracic Paravertebral Block Using Real-Time Ultrasound Guidance,” Anesthesia & Analgesia, Vol. 110, No. 1, 2010, pp. 248-251. doi:10.1213/ANE.0b013e3181c35906
[7] A. Ben-Ari, M. Moreno, J. E. Chelly, et al., “Ultrasound-Guided Paravertebral Block Using an Intercostal Approach,” Anesthesia & Analgesia, Vol. 109, No. 5, 2009, pp. 1691-1694. doi:10.1213/ANE.0b013e3181b72d50
[8] C. Luyet, U. Eichenberger, R. Greif, et al., “Ultrasound-Guided Paravertebral Puncture and Placement of Catheters in Human Cadavers: An Imaging Study,” British Journal of Anesthesia, Vol. 102, No. 4, 2009, pp. 534-539. doi:10.1093/bja/aep015
[9] F. Pusch, E. Wilding, W. Klimscha, et al., “Sonographic Measurement of Needle Insertion Depth in Paravertebral Blocks in Womem,” British Journal of Anesthesia, Vol. 85, No. 6, 2000, pp. 841-843. doi:10.1093/bja/85.6.841
[10] L. Kirchmair, T. Entner, J. Wissel, et al., “A Study of the Paravertebral Anatomy for Ultrasound-Guided Posterior Lumbar Plexus Block,” Anesthesia & Analgesia, Vol. 93, No. 2, 2001, pp. 477-481.
[11] J. Richardson and P. A. Lonnqvist, “Thoracic Paravertebral Block,” British Journal of Anesthesia, Vol. 81, No. 2, 1998, pp. 230-238. doi:10.1093/bja/81.2.230
[12] D. A. Burns, B. Ben-David, J. E. Chelly, et al., “Intercostally Placed Paravertebral Catheterization: An Alternative Approach to Continuous Paravertebral Blockade,” Anesthesia & Analgesia, Vol. 107, No. 1, 2008, pp. 339-341. doi:10.1213/ane.0b013e318174df1d
[13] G. Purcell-Jones, C. E. Pither and D. M. Justins, “Paravertebral Somatic Nerve Block: A Clinical, Radiographic and Computed Tomographic Study in Chronic Pain Patients,” Anesthesia & Analgesia, Vol. 68, No. 1, 1989, pp. 32-39. doi:10.1213/00000539-198901000-00008
[14] I. D. Conacher and M. Kokri, “Postoperative Paravertebral Blocks for Thoracic Surgery. A Radiological Appraisal,” British Journal of Anesthesia, Vol. 59, No. 2, 1987, pp. 155-161. doi:10.1093/bja/59.2.155

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