Sato, Y.*
Junjindo Yuza Hospital, Anesthesia and Pain Medicine, Yuza, Japan
ESRA Academy. Sato Y. Sep 13, 2017; 190900; 228
Prof. Yutaka Sato
Prof. Yutaka Sato

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Background and Aims:

In recent years, increasing interest in regional anesthesia for unilateral thoracic wall surgery was widespread from industrialized countries to developing countries. Hence many proposals were published among scientific literatures for regional anesthesia techniques under various nomenclatures for such seemingly almost identical point of injection, local anesthetics dosage and clinical results. Some of the clinical reports provide with an anatomical study and tried to evaluate the mechanism of action of their proposed technique. However, the numbers of these anatomical studies were small and the results were not conclusive to clarify the mechanism of these blocks.



Authors collected and reviewed anesthetic literatures concerning the key word under the title of ” Paraverterbal lamina technique, Retrolaminar paravertebral block, Costvertebral canal block, Erector spinae muscle plane block or Paraspinal injection technique. These reports were analyzed according to their block technique, clinical results, presumed mechanism by radiographic and/or anatomical studies.


All these reports claimed that the extent of analgesia was sufficient to undergo unilateral thoracic wall surgeries. However, these techniques could not provide analgesia for parasternal area. Anatomical and radiographic studies revealed the spread of injected dye was seen within myofascial layer of transversospinal muscles and/or erector spinae muscles, and seldom seen in thoracic paravertebral space.


Author concluded that the mechanism of these injection techniques may be different from that of the standard thoracic paravertebral block. Further studies will be needed to clarify the exact mechanism of these relatively simple, safe and effective blocks for unilateral thoracic wall surgery.

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