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SINGLE SHOT ULTRASOUND GUIDED PARAVERTEBRAL BLOCK FOR TYPE C ESOPHAGEAL ATRESIA REPAIR IN NEWBORNS
Author(s): ,
rahil, O.*
Affiliations:
clinique ALI BOUZID, EPH EL BIAR BIRTRARIA EL BIAR, ALGIERS, Algeria
,
benslimane, M.
Affiliations:
clinique ALI BOUZID, EPH EL BIAR BIRTRARIA EL BIAR, ALGIERS, Algeria
bouchabou , B.
Affiliations:
clinique ALI BOUZID, EPH EL BIAR BIRTRARIA EL BIAR, ALGIERS, Algeria
ESRA Academy. rahil o. Sep 15, 2017; 196145
ouahid rahil
ouahid rahil
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Abstract
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Background and Aims:

Ultrasound guided paravertebral block (UGPVB), is one of the most effective regional anesthesia  technique for perioperative pain management in thoracic surgery. Unfortunately, there are few descriptions of this block in neonatal surgery  .We describe our experience in single shot UGPVB in newborns undergoing  type C esophageal atresia (OA)  repair.

Methods:

Twenty newborns (NB) scheduled for type C OA repair were included in this prospective observational study . A right UGBPV was performed in intubated  asleep newborns (propofol without opioids) . After tracheal intubation NB were placed in left Lateral decubitus.  In plane puncture with a hight frequency linear probe was Performed using an intercostal approach at the level of the forth dorsal vertebrae (D 04) followed by injection of 0.5 ml / kg Of ropivacaine 0.2%.  We considered as insufficient  surgical analgesia  any increase in heart rate beyond 20% of baseline  and requiered iv alfentanyl (0,01mg/kg) .Post operative pain was evaluated  using the EDIN scale (every 4 hours) during The first 24 hours. All newborns received  intravenous paracetamol (7,5mg/kg/6h) We ‘ve Noted vascular punctures, pneumothorax as well as technical failures.

Results:

 Mean age was 36 post menstrual weeks (33-40) . Mean weight was 2050 g (1200-3600). All patients had a primary surgical repair . A NB (05%) required intra operative analgesia  but none in postoperative. No pneumothorax or vascular puncture were noted .We had two immediate post-operative deaths.

Conclusions:

Single shot UGPVB provides  optimal périoperative pain management in type C OA repair avoiding opioids use & their side effects,  especially on newborns .

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