Abstract
Ultrasound guided nerve blocks are gaining popularity these days due to its higher accuracy and reduced incidence of complications. Ultrasound guided unilateral paravertebral block in combination with unilateral coeliac plexus block and unilateral Rectus sheath block in patients with multiple co-morbidities provides adequate anesthesia for surgery and it also reduces incidences of mortality, morbidity and hospital stay in comparison to General anesthesia and spinal / epidural anesthesia. Paravertebral block , Coeliac plexus block and Rectus sheath blocks can be performed with higher success rate with the use of ultrasound. BJHS 2018;3(2)6:508-510.
Highlights
Open Cholecystectomy is commonly performed under general anesthesia with endotracheal intuba on using muscle relaxant or regional anesthesia using either high spinal blocks or thoracic epidural technique.[1]
In pa ents having mul ple cardiopulmonary problems ultrasound guided unilateral right thoracic paravertebral block in combina on with right coeliac plexus block and right sided Rectus sheath block can be safely used for pa ents planned for open cholecystectomy as this is a rou ne prac ce in our ins tute.[2,34]
Considering the comorbid condi ons and the anaesthesia risk, the pa ent was given the choice for regional anesthesia with ultrasound guided Thoracic Paravertebral and Coeliac plexus block
Summary
Open Cholecystectomy is commonly performed under general anesthesia with endotracheal intuba on using muscle relaxant or regional anesthesia using either high spinal blocks or thoracic epidural technique.[1]. The pa ent was under medica on for COPD since 20 yrs, hypertensive under medica on since 16 yrs and was diabe c since 10 yrs under medica on and with oral an diabe c medica ons his blood sugar level was within normal/acceptable level. Considering the comorbid condi ons and the anaesthesia risk, the pa ent was given the choice for regional anesthesia with ultrasound guided Thoracic Paravertebral and Coeliac plexus block. Once the p of the needle was visualized in the paravertebral space, 20 ml of 1.5% lignocaine with adrenaline was with the pa ent s ll in the le lateral posi on, right sided coeliac plexus was approached from posterior side. The scanning image was op mized to get muscle , TP- Transverse process
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