Evaluation of thoracic paravertebral block for pain relief in rib fractures
Introduction: Fracture of ribs causes severe pain which in turn activates the cascade of respiratory compromise. Pain management with regional blocks is considered one of the promising techniques. Thoracic paravertebral block (TPVB) is a proven technique considered at par with epidural analgesia. Bu...
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| Format: | Article |
| Language: | English |
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National Scientific Medical Center
2023-12-01
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| Series: | Ķazaķstannyṇ Klinikalyķ Medicinasy |
| Subjects: | |
| Online Access: | https://www.clinmedkaz.org/download/evaluation-of-thoracic-paravertebral-block-for-pain-relief-in-rib-fractures-13874.pdf |
| _version_ | 1827390828124831744 |
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| author | Tarun Yadav Gunjan Bansal Mayuri Golhar Anju Ghai |
| author_facet | Tarun Yadav Gunjan Bansal Mayuri Golhar Anju Ghai |
| author_sort | Tarun Yadav |
| collection | DOAJ |
| description | Introduction: Fracture of ribs causes severe pain which in turn activates the cascade of respiratory compromise. Pain management with regional blocks is considered one of the promising techniques. Thoracic paravertebral block (TPVB) is a proven technique considered at par with epidural analgesia. But its blind landmark-based technique has a potential risk of pneumothorax. Ultrasound gives advantage of real time visualization which decreases complications and enhance its success rate. So, we conducted this study to gauge the efficacy and utility of ultrasound guided thoracic paravertebral block.
Material and methods: Twenty patients were administered TPVB under ultrasound guidance with 15 milliliters of 0.25 % inj bupivacaine and 2 mg per kg fentanyl who had multiple rib fractures of unilateral hemithorax. For prolonged pain relief a catheter was left in place to administer recurring boluses. The parameters noted were superior costotransverse ligament (SCTL), skin to SCTL distance, skin to pleura distance, VAS at rest & at cough, respiratory rate arterial blood gas parameters at various time intervals.
Results: Thoracic paravertebral space was easily identified in each patient with ultrasound. We discovered significant pain relief in terms of VAS score at rest & at cough at different time intervals. Respiratory rate and arterial blood gas parameters improved with the use of ultrasound guided thoracic paravertebral block.
Conclusion: Sonographic out of plane sagittal thoracic paravertebral block is a successful technique in rib fracture patients to provide effective pain relief and also ameliorates respiratory rate and oxygenation. |
| first_indexed | 2024-03-08T16:59:33Z |
| format | Article |
| id | doaj.art-0b6712a9e277475fbfd4b2ae3d3c9908 |
| institution | Directory Open Access Journal |
| issn | 1812-2892 2313-1519 |
| language | English |
| last_indexed | 2024-03-08T16:59:33Z |
| publishDate | 2023-12-01 |
| publisher | National Scientific Medical Center |
| record_format | Article |
| series | Ķazaķstannyṇ Klinikalyķ Medicinasy |
| spelling | doaj.art-0b6712a9e277475fbfd4b2ae3d3c99082024-01-04T14:55:05ZengNational Scientific Medical CenterĶazaķstannyṇ Klinikalyķ Medicinasy1812-28922313-15192023-12-01206414410.23950/jcmk/13874Evaluation of thoracic paravertebral block for pain relief in rib fracturesTarun Yadav0Gunjan Bansal1Mayuri Golhar2Anju Ghai3Department of Anaesthesia and Critical Care, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, IndiaDepartment of Health, Haryana Civil Medical Services, Government of Haryana, Haryana, IndiaDepartment of Anaesthesia and Critical Care, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, IndiaDepartment of Anaesthesia and Critical Care, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, IndiaIntroduction: Fracture of ribs causes severe pain which in turn activates the cascade of respiratory compromise. Pain management with regional blocks is considered one of the promising techniques. Thoracic paravertebral block (TPVB) is a proven technique considered at par with epidural analgesia. But its blind landmark-based technique has a potential risk of pneumothorax. Ultrasound gives advantage of real time visualization which decreases complications and enhance its success rate. So, we conducted this study to gauge the efficacy and utility of ultrasound guided thoracic paravertebral block. Material and methods: Twenty patients were administered TPVB under ultrasound guidance with 15 milliliters of 0.25 % inj bupivacaine and 2 mg per kg fentanyl who had multiple rib fractures of unilateral hemithorax. For prolonged pain relief a catheter was left in place to administer recurring boluses. The parameters noted were superior costotransverse ligament (SCTL), skin to SCTL distance, skin to pleura distance, VAS at rest & at cough, respiratory rate arterial blood gas parameters at various time intervals. Results: Thoracic paravertebral space was easily identified in each patient with ultrasound. We discovered significant pain relief in terms of VAS score at rest & at cough at different time intervals. Respiratory rate and arterial blood gas parameters improved with the use of ultrasound guided thoracic paravertebral block. Conclusion: Sonographic out of plane sagittal thoracic paravertebral block is a successful technique in rib fracture patients to provide effective pain relief and also ameliorates respiratory rate and oxygenation.https://www.clinmedkaz.org/download/evaluation-of-thoracic-paravertebral-block-for-pain-relief-in-rib-fractures-13874.pdfultrasoundpain reliefrib fracturethoracic paravertebral block |
| spellingShingle | Tarun Yadav Gunjan Bansal Mayuri Golhar Anju Ghai Evaluation of thoracic paravertebral block for pain relief in rib fractures Ķazaķstannyṇ Klinikalyķ Medicinasy ultrasound pain relief rib fracture thoracic paravertebral block |
| title | Evaluation of thoracic paravertebral block for pain relief in rib fractures |
| title_full | Evaluation of thoracic paravertebral block for pain relief in rib fractures |
| title_fullStr | Evaluation of thoracic paravertebral block for pain relief in rib fractures |
| title_full_unstemmed | Evaluation of thoracic paravertebral block for pain relief in rib fractures |
| title_short | Evaluation of thoracic paravertebral block for pain relief in rib fractures |
| title_sort | evaluation of thoracic paravertebral block for pain relief in rib fractures |
| topic | ultrasound pain relief rib fracture thoracic paravertebral block |
| url | https://www.clinmedkaz.org/download/evaluation-of-thoracic-paravertebral-block-for-pain-relief-in-rib-fractures-13874.pdf |
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