Serratus Anterior Plane Block and Intercostal Nerve Block after Thoracoscopic Surgery
Conclusion In the patients who underwent S-VATS with primary spontaneous pneumothorax, the SAPB provided similar postoperative pain relief with reducing the NSAIDs consumption compared with ICNB. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents | Abstract | Full text
Conclusion: US guided ESPB is quite effective in reducing perioperative pain in patients undergoing mastectomy. The trial was registered prospectively with CTRI with registration number: CTRI/2018/09/015668.
We read with interest the recent paper discussing an ultrasound guided oblique intercostal approach for paravertebral catheters placement in 2 neonates scheduled for tracheoesophageal fistula repair . While we applaud the author's choice of using for paravertebral catheters (PVBCs) in such small neonates, we question the technique used; an ultrasound image was not presented, and the figure and block details do not seem to be in concordance with the approach used. The depth of paravertebral space with intercostal approach is only few millimiters, making this approach extremely challenging, with a high risk of pneumothora...
Low risk of pneumothorax, catheter misplacement after ultrasound - guided procedure
CONCLUSIONS: This is the first known case in the literature of direct viewing of LA diffusion in a paravertebral space other than the one in which the block is administered and may open important scenarios for the improvement of anesthesia technique. PMID: 29714650 [PubMed - as supplied by publisher]
Conclusion: To our knowledge, this is the first case series of pneumomediastinum in patients with pulmonary fibrosis following EBUS-TBNA. We believe the radial traction placed on the airways (splinting) by the fibrotic lung disease and the increased airway pressure may have allowed air in to the mediastinum through the needle puncture sites. Both physicians and patients should be aware of this complication and we suggest a smaller 22 G EBUS-TBNA needle be used in patients with pulmonary fibrosis.
This study shows TPVB is a well‐tolerated procedure, with a low associated incidence of iatrogenic injury and complication.
This article describes the normal and pathological findings that can be used to quickly and confidently evaluate a patient for these conditions.
(Abstracted from Anesth Analg, 122:1186–1191, 2016) Thoracic paravertebral block (TPVB) produces ipsilateral somatic and sympathetic nerve blockade across several contiguous dermatomes and is known to effectively control acute postoperative pain. However, it is associated with serious potential complications, such as pneumothorax from pleural puncture and occasional local anesthetic toxicity.
Thoracic paravertebral blocks (TPVBs) have an extensive evidence base as part of a multimodal analgesic strategy for thoracic and breast surgery and have gained popularity with the advent of ultrasound guidance. However, this role is poorly defined in the context of abdominal surgery. We performed a systematic review of randomized controlled trials, to clarify the impact of TPVB on perioperative analgesic outcomes in adult abdominal surgery. We identified 20 published trials involving a total of 1044 patients that met inclusion criteria; however there was significant heterogeneity in terms of type of surgery, TPVB techniqu...
Conclusion US-guided Sup-SCV catheterisation appears to be fast and safe in children and neonates, even if it remains a little more difficult to achieve in lower-weight patients.