Abstract
Recently, the use of paravertebral block (PVB) during thoracic surgery has been re-evaluated, as it is not inferior to epidural anaesthesia for postoperative pain control, and has been associated with fewer complications (e.g., hematoma of epidural, hypotension, urinary retention, postoperative nausea and vomiting). No reports have described intraoperative catheterization for PVB during single-incision thoracoscopic surgery (SITS) as distinct from thoracotomy or multi-ports video-assisted thoracoscopic surgery. We describe a case of SITS bullectomy using a chest wall pulley for lung excision to treat primary spontaneous pneumothorax and 25 catheterizations for PVB during SITS that have been performed since June 2013. Our novel technique is both easy and safe. It is ideal to combine PVB with SITS because both methods are less invasive.
References
Kobayashi R, Mori S, Wakai K, Fukumoto K, Saito T, Katayama T, et al. Paravertebral block via the surgical field versus epidural block for patient undergoing thoracotomy: randomized clinical trial. Surg Today. 2013;43:963–9.
Marhofer P, Kettner SC, Hajbok L, Dubsky P, Fleischmann E. Lateral ultrasound-guided paravertebral blockade: an anatomical-based description of a new technique. Br J Anaesth. 2010;105:526–32.
Naja MZ, Ziade MF, El Rajab M, El Tayara K, Lönnqvist PA. Varying anatomical injection points within the thoracic paravertebral space: effect on spread of solution and nerve blockade. Anaesthesia. 2004;59:459–63.
Tsuboshima K, Wakahara T, Matoba Y, Miyauchi H, Hayashi C, Kobayashi I, et al. Single-incision thoracoscopic surgery using chest wall pulley for lung excision in primary spontaneous pneumothorax cases. Surg Today. 2015;45:595–9.
Soni AK, Conacher ID, Waller DA, Hilton CJ. Video-assisted thoracoscopic placement of paravertebral catheters: a technique for postoperative analgesia for bilateral thoracoscopic surgery. Br J Anaesth. 1994;72:462–4.
Komatsu T, Sowa T, Takahashi K, Fujinaga T. Paravertebral block as a promising analgesic modality for managing post-thoracotomy pain. Ann Thorac Cardiovasc Surg. 2014;20:113–6.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
None declared.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Tsuboshima, K., Nagata, M., Wakahara, T. et al. Novel paravertebral block during single-incision thoracoscopic surgery for primary spontaneous pneumothorax. Gen Thorac Cardiovasc Surg 64, 58–61 (2016). https://doi.org/10.1007/s11748-015-0584-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11748-015-0584-1