Bilateral thoracic paravertebral block: potential and practice

被引:127
作者
Richardson, J. [1 ]
Lonnqvist, P. A. [2 ]
Naja, Z. [3 ]
机构
[1] Bradford Royal Infirm, Dept Pain & Anaesthet, Bradford BD9 6RJ, W Yorkshire, England
[2] Karolinska Inst, Stockholm, Sweden
[3] Makassed Gen Hosp, Beirut, Lebanon
关键词
anaesthetic techniques; regional; paravertebral; pain; postoperative; INTERCOSTAL NERVE BLOCK; BREAST-CANCER SURGERY; POSTTHORACOTOMY PAIN; POSTOPERATIVE ANALGESIA; INTERPLEURAL ANALGESIA; PLASMA-CONCENTRATIONS; PULMONARY-FUNCTION; RANDOMIZED-TRIALS; HUMAN CADAVERS; HERNIA REPAIR;
D O I
10.1093/bja/aeq378
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Paravertebral nerve blocks (PVBs) can provide excellent intraoperative anaesthetic and postoperative analgesic conditions with less adverse effects and fewer contraindications than central neural blocks. Most published data are related to unilateral PVB, but its potential as a bilateral technique has been demonstrated. Bilateral PVB has been used successfully in the thoracic, abdominal, and pelvic regions, sometimes obviating the need for general anaesthesia. We have reviewed the use of bilateral PVB in association with surgery and chronic pain therapy. This covers 12 published studies with a total of 538 patients, and with varied methods and outcome measures. Despite the need for relatively large doses of local anaesthetics, there are no reports of systemic toxicity. The incidence of complications such as pneumothorax and hypotension is low. More studies on the use of bilateral PVB are required.
引用
收藏
页码:164 / 171
页数:8
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