Ultrasound-guided Continuous Paravertebral Block Research Articles

Comparison of ultrasound-guided continuous erector spinae plane block versus continuous paravertebral block for postoperative analgesia in patients undergoing proximal femur surgeries.

Proximal femur fracture surgeries have become increasingly prevalent, presenting unique challenges for postoperative pain management due to patient demographics and comorbidities. Erector spinae plane block (ESPB) has emerged as a relatively safe alternative to paravertebral block (PVB). Our aim was to compare ultrasound-guided continuous ESPB with continuous PVB for postoperative analgesia in patients undergoing proximal femur surgeries under spinal anesthesia. A prospective randomized interventional study was conducted on 60 patients between 18 and 60 years of age undergoing proximal femur surgeries under spinal anesthesia with American Society of Anesthesiologists physical status I and II between January 2019 and April 2020. Patients were randomly assigned to receive either ultrasound-guided continuous ESPB (Group E, n = 30) or ultrasound-guided continuous PVB (Group P, n = 30) using a computer-generated randomization table. The mean maximum visual analog scale (VAS) score, VAS score in the first 24 h, the time of rescue analgesia, and total requirement of rescue analgesia were assessed. The maximum VAS score within the first 24 h was numerically higher in Group P but statistically insignificant (p-value 0.279). VAS scores at 0, 1, 2, 6, and 18 h postoperatively were comparable in both groups. However, at the 24-h mark, the VAS score between Group E and Group P was statistically significant (p-value 0.018) but not clinically relevant. The mean paracetamol and tramadol requirements were comparable between the two groups. Continuous ESPB is as effective as continuous PVB for postoperative analgesia in proximal femur surgeries. The enhanced safety profile of erector spinae block underscores its significance in postoperative pain management.

Ultrasound-guided continuous paravertebral block in management of Askin's tumor in an elderly patient

Ultrasound-guided continuous paravertebral block in management of Askin's tumor in an elderly patient

The Effect of Fentanyl or Dexmedetomidine on the Ultrasound-Guided Paravertebral Block for Patients Undergoing Renal Surgeries: Randomized Controlled Trial

Objective: This study aimed to investigate the effect of the continuous paravertebral block using either fentanyl or dexmedetomidine as an additive to bupivacaine in patients undergoing renal surgeries. Methods: Ninety adult patients presented for renal surgeries under general anesthesia and ultrasound-guided continuous paravertebral block were allocated in this study and randomly distributed into three groups. All the patients received a loading and a maintenance doses of local anesthetic mixtures composed of bupivacaine alone in Control group with addition of fentanyl or dexmedetomidine in Fentanyl and Dexmedetomidine groups. The measurements included the postoperative analgesic consumption, the time for the first request for rescue analgesia, postoperative pain scores, hemodynamic parameters, and incidence of complication. Results: The addition of fentanyl or dexmedetomidine to plain bupivacaine in continuous paravertebral block significantly decreased the dose of postoperative morphine consumption from (11.33 ± 5.05 mg) to (7.33 ± 4.59 mg) (7.80 ± 4.15mg), significantly prolonged the time for first request of rescue analgesia from (6.87 ± 3.81 h) to (9.80 ± 4.50 h) (10.80 ± 5.22 h), and significantly decrease VAS score 2 h and 6 h postoperatively with insignificant difference between fentanyl and dexmedetomidine (p>0.05). Conclusion: Fentanyl or dexmedetomidine can be helpful as an adjuvant to bupivacaine (0.25%) in the continuous paravertebral block as they decreased the postoperative analgesic consumption without increased incidence of complication.

Ultrasound guided continuous paravertebral block in a patient with coronary heart disease and sleep apnea syndrome

The case of a 77-year-old patient with severe coronary heart disease who underwent radical mastectomy with axillary lymph node dissection by ultrasound-guided continuous paravertebral block (CPVB) is described in the present report. Radical mastectomy with axillary dissection is a surgical procedure that necessitates endotracheal intubation and is usually performed under general anesthesia, which carries heightened risk for patients with coronary heart disease (CHD) and sleep apnea syndrome (SAS). Ultrasound-guided CPVB is a simple and safe alternative technique that allows for the use of anesthesia and postoperative analgesia with minimal side effects.

Ultrasound-guided continuous paravertebral block in isolated thoracic trauma – providing sufficient analgesia for weaning and non-invasive-ventilation (NIV) on ICU for a 46 year old patient after high-speed trauma

After acute high-velocity injury it is desirable to avoid thoracic epidural analgesia to povide neurological examination of the spinal cord function. Systemic analgesia is often insufficient to tolerante non-invasive ventilation (NIV) in massive thoracic trauma and often leads to reintubation and subsequent dilation tracheotomy.

Ultrasound-guided continuous paravertebral block in isolated thoracic trauma - providing sufficient analgesia for weaning and non-invasive-ventilation (NIV) on ICU for a 46 year old patient after high-speed trauma

Ultrasound-guided continuous paravertebral block in isolated thoracic trauma - providing sufficient analgesia for weaning and non-invasive-ventilation (NIV) on ICU for a 46 year old patient after high-speed trauma