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Ultrasound Guided Thoracic Paravertebral Block in Thoracic Surgery: -Observational Study-.

Author: Abderrahim El Bouazzaoui, Soumaya Touzani, Nawfal Houari, Brahim Bouykatta, Nabil Kanjaa

Category: JMSR Anesthesiology and IC


Introduction:The paravertebral block (PVB) is a unilateral anesthesia of the trunk which showed its effectiveness in many surgical indications. The aim of this our study is to evaluate the interest of the PVB in the analgesia after thoracotomy. Methodology:All patients were older than 12 years old, and were to benefit from PVB for any thoracic surgery by thoracotomy. Data concerning the ultrasound locating of the paravertebral space, the puncture, the analgesics data according to the visual analogue scale (VAS), and complications of the technique were collected. Results: We had 16 patients, with a median age of 36 years old, were prospectively included over 8 months. The anatomical structures identified through ultrasound guidance were: the transverse process (100% of cases), the costo-transverse ligament (44%), the parietal pleura (100%). The needle was displayed throughout his trajectory in 81% of patients. The extremity of the needle is displayed in 93% of cases. The anterior displacement of the pleura was noted in 94% of cases. The mean VAS during the rest was [3, 73-0] for 48 hours and during effort has varied VAS average of [5.6 to 0.5]. The dose of morphine received during the 48heurs was 13mg. No complications were recorded. After extubation the mean VAS was 5 and the dose of morphine received in the post-operative room was 3.5 mg. Conclusion: The paravertebral block is a simplified technique allowing analgesia after major surgery of the thorax. This technique can thus advantageously replace thoracic epidural analgesia with fewer major complications.

Keywords: Analgesia, Chest pain, Pulmonary resection, Thoracic para-vertebral block, Thoracotomy



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