View clinical trials related to Thoracic Paravertebral Block.
Filter by:The growing increase in the number of gynecomastia surgeries has resulted in an increased need for anesthetic techniques with improved pain reduction, safety, and fewer complications. The aim of this work is to compare the efficacy of ultrasound guided thoracic interfascial plane block and ultrasound guided thoracic paravertebral block for anesthesia in gynecomastia surgery.
Pain after hepatectomy can interfere with the patients' recovery and may contribute to developing long term pain. Opioids, e.g. morphine, fentanyl, sufentanil, works well for postoperative analgesia, but have several side effects such as nausea, vomiting and itching which may be severe enough to affect patients' recovery. In some cases, opioids may cause constipation and urinary retention within the first 24 hours after surgery. Thus, several ultrasound-guided nerve block procedures have been applied to provide postoperative analgesia. Ultrasound-guided thoracic paravertebral block (TPVB) is one of the most used nerve block methods using for post-hepatectomy analgesia. However, in some cases, ultrasound-guided TPVB can cause pneumothorax, hemopneumothorax, and higher block level. The quadratus lumborum block (QLB) is a new developed nerve block which can provide a widespread analgesic effect from T7 to L1. Therefore, this study is to determine whether QLB or TPVB have a better pain control with fewer side effects and complications after laparoscopic and open hepatectomy. The adequate pain control will be assessed by their visual analogue score (VAS) and the postoperative quality of recovery scale (QoR-15, Chinese Version). Additionally, the side effect and complications profile of these two nerve block techniques will also be recorded and compared.
The Left thoracic paravertebral block have a different effect on heart's autonomic nervous system, as measured with Heart Rate Variability, compared to Right interscalene block
Thoracic operations are known to be painful and requiring an adequate postoperative pain therapy. A well documented technique to achieve postoperative analgesia is the use of paravertebral catheters. Theoretically the thoracic paravertebral block results in an unilateral thoracic anaesthesia. However, in the daily clinical practice it remains unclear whether catheters are placed correctly into the paravertebral region. The investigators' experiences with paravertebral catheters suggest that there may be many displacements of catheters since the pain control is reduced compared to epidural analgesia. The aim of this prospective observational clinical trial is to postoperatively evaluate the exact location of paravertebral catheter placed for thoracoscopic interventions by using the classical land-mark puncture technique. After radiological detection of the catheter position, the spread and distribution of contrast dye injected through the catheters will be evaluated.