Save
T1, T2 PARAVERTEBRAL NERVE BLOCKS FOR POST OPERATIVE ANALGESIA AFTER FIRST RIB RESECTION FOR THORACIC OUTLET SYNDROME
ESRA Academy. Kalava A. Sep 8, 2016; 138371; 0211 Topic: MISCELLANEOUS
Dr. Arun Kalava
Dr. Arun Kalava

Access to Premium content is currently a membership benefit.


Click here to join ESRA or renew your membership.

Abstract
Discussion Forum (0)
Rate & Comment (0)
Background and Aims:

Thoracic outlet syndrome (TOS) rarely requires surgery and postoperative pain is managed with opioids either on an on needed basis or as patient controlled analgesia (PCA).  We report the use of T 1, T 2 paravertebral nerve blocks (PVBs) for post- operative analgesia after first fib resection for thoracic outlet syndrome (TOS).

Methods:

 

After informed consent, PVBs were performed using the traditional landmark technique in 3 different patients.  The C7 spinous process (most prominent) and T 1 were identified using palpation. A 5 mL injectate of 1% ropivacaine was then deposited in the paravertebral space after confirmation of no aspiration to blood and no paresthesias.  The success of the block was confirmed using loss of temperature sensation to ice in the corresponding dermatomes i.e., T 1 and T2.

Post operatively patients were placed on IV hydromorphone PCA and pain scores were recorded frequently and the amount of hydromorphone consumed in 24 hours was assessed.

 

Results:

Of the 3 patients observed, one had bilateral 1st rib resections each performed at separate time periods allowing us to analyze a total of 4 blocks and their efficacy in managing postoperative pain after surgery.  Total hydromorphone consumption was 2 mg or less in the first 24 hours among all 4 observed surgeries and patients reported very good pain relief.

Conclusions:

T1 and T2 PVBs seem a good analgesic option in patients undergoing 1st rib resection for neurogenic TOS.

Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.


Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.



Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.


Save Settings