A Comparative Study of Automated Pulsed Bolus Versus Continuous Basal Infusion on Distribution of Dye in the Paravertebral Space in a Cadaver.

Steven R Clendenen,Elird Bojaxhi

doi:10.7759/cureus.4958

Steven R Clendenen, Elird Bojaxhi

Open Access

https://doi.org/10.7759/cureus.4958

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Abstract

Adequate pain control following thoracic surgery is important to enhance post-operative recovery. Paravertebral catheters have been reported to have a variety of clinical applications, including the blunting of surgical pain, lessening the need for opioids, and improvement in post-operative ventilation. The spread of local anesthesia to multiple paravertebral spaces is needed to establish an effective block. We have determined that the spread of contrast dye by a catheter in the thoracic paravertebral space is greater in a programmed intermittent bolus than in a continuous basal infusion.

Highlights

A variety of methods have been used for the delivery of local anesthetics by catheters for a continuous nerve block, including elastomer and electronic pumps
Some of the newer electronic models have the capability of programmed intermittent bolus (PIB) in contrast to continuous basal infusion (CI)
Catheters in the thoracic paravertebral space are used to deliver a continuous infusion of local anesthetics in order to provide prolonged analgesia following chest surgery [1,2]

Summary

Introduction

A variety of methods have been used for the delivery of local anesthetics by catheters for a continuous nerve block, including elastomer and electronic pumps. Some of the newer electronic models have the capability of programmed intermittent bolus (PIB) in contrast to continuous basal infusion (CI) This feature can potentially improve the efficacy of a nerve block by expanding the spread of local anesthetic in the perineural space. Catheters in the thoracic paravertebral space are used to deliver a continuous infusion of local anesthetics in order to provide prolonged analgesia following chest surgery [1,2]. The efficacy of the block for postoperative analgesia is dependent on the spread of local anesthesia to multiple levels of the paravertebral space. How to cite this article Clendenen S R, Bojaxhi E (June 20, 2019) A Comparative Study of Automated Pulsed Bolus Versus Continuous Basal Infusion on Distribution of Dye in the Paravertebral Space in a Cadaver. At each interval of dosing at 10, 15, and 20 ml, there was a greater rostral spread and circumferential expansion of the dye in the PIB catheter when compared to the CI catheter

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Disclosures