A Modified Approach for Ultrasound-Guided Thoracic Paravertebral Block via Thoracic Intervertebral Foramen in an Adolescent Patient: A Case Report
This case report describes a modified approach for a thoracic paravertebral block by performing a bilateral ultrasound-assisted injection of 12 mL of 0.5% levobupivacaine near the thoracic intervertebral foramen, combined with general anesthesia, in a patient who underwent emergent laparotomy for sm...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-05-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/11/9/2646 |
| _version_ | 1797504123576254464 |
|---|---|
| author | Emiliano Petrucci Franco Marinangeli Barbara Pizzi Francesco Sciorio Gioele Marrocco Massimo Antonio Innamorato Marco Cascella Alessandro Vittori |
| author_facet | Emiliano Petrucci Franco Marinangeli Barbara Pizzi Francesco Sciorio Gioele Marrocco Massimo Antonio Innamorato Marco Cascella Alessandro Vittori |
| author_sort | Emiliano Petrucci |
| collection | DOAJ |
| description | This case report describes a modified approach for a thoracic paravertebral block by performing a bilateral ultrasound-assisted injection of 12 mL of 0.5% levobupivacaine near the thoracic intervertebral foramen, combined with general anesthesia, in a patient who underwent emergent laparotomy for small intestinal volvulus. Two continuous catheter sets were used for a bilateral continuous block with levobupivacaine 0.25% at a rate of 5–8 mL/h. No complications during the execution of the block were recorded. No supplemental opioids were administered and the patient was hemodynamically stable, requiring no pharmacological cardiovascular support during surgery. At the end of the surgical procedure, the patient received a continuous flow of 0.2% levobupivacaine as postoperative analgesia, at a basal flow of 4 mL/h per each side, a bolus of 4 mL, and a lockout time of 60 min was used. The postoperative pain on the Numeric Rating Scale was 2 at rest and it was 4 in motion, without neurological or respiratory sequelae due to block in the first 72 h after surgery. |
| first_indexed | 2024-03-10T04:00:11Z |
| format | Article |
| id | doaj.art-25ff847f7db8423f9d95ac7760de5ac1 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T04:00:11Z |
| publishDate | 2022-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-25ff847f7db8423f9d95ac7760de5ac12023-11-23T08:35:25ZengMDPI AGJournal of Clinical Medicine2077-03832022-05-01119264610.3390/jcm11092646A Modified Approach for Ultrasound-Guided Thoracic Paravertebral Block via Thoracic Intervertebral Foramen in an Adolescent Patient: A Case ReportEmiliano Petrucci0Franco Marinangeli1Barbara Pizzi2Francesco Sciorio3Gioele Marrocco4Massimo Antonio Innamorato5Marco Cascella6Alessandro Vittori7Department of Anesthesia and Intensive Care Unit, San Salvatore Academic Hospital of L’Aquila, Via Vetoio 48, 67100 L’Aquila, ItalyDepartment of Anesthesiology, Intensive Care and Pain Treatment, University of L’Aquila, Piazzale Salvatore Tommasi 1, Coppito, 67100 L’Aquila, ItalyDepartment of Anesthesia and Intensive Care Unit, SS Filippo and Nicola Academic Hospital of Avezzano, Avezzano, 67051 L’Aquila, ItalyDepartment of Anesthesiology, Intensive Care and Pain Treatment, University of L’Aquila, Piazzale Salvatore Tommasi 1, Coppito, 67100 L’Aquila, ItalyDepartment of Anesthesiology, Intensive Care and Pain Treatment, University of L’Aquila, Piazzale Salvatore Tommasi 1, Coppito, 67100 L’Aquila, ItalyDepartment of Neuroscience, Pain Unit, Santa Maria delle Croci Hospital, AUSL Romagna, Viale Vincenzo Randi 5, 48121 Ravenna, ItalyDepartment of Anesthesia and Critical Care, Istituto Nazionale Tumori—IRCCS, Fondazione Pascale, Via Mariano Semmola 53, 80131 Naples, ItalyDepartment of Anesthesia and Critical Care, ARCO ROMA, Ospedale Pediatrico Bambino Gesù IRCCS, Piazza S. Onofrio 4, 00165 Rome, ItalyThis case report describes a modified approach for a thoracic paravertebral block by performing a bilateral ultrasound-assisted injection of 12 mL of 0.5% levobupivacaine near the thoracic intervertebral foramen, combined with general anesthesia, in a patient who underwent emergent laparotomy for small intestinal volvulus. Two continuous catheter sets were used for a bilateral continuous block with levobupivacaine 0.25% at a rate of 5–8 mL/h. No complications during the execution of the block were recorded. No supplemental opioids were administered and the patient was hemodynamically stable, requiring no pharmacological cardiovascular support during surgery. At the end of the surgical procedure, the patient received a continuous flow of 0.2% levobupivacaine as postoperative analgesia, at a basal flow of 4 mL/h per each side, a bolus of 4 mL, and a lockout time of 60 min was used. The postoperative pain on the Numeric Rating Scale was 2 at rest and it was 4 in motion, without neurological or respiratory sequelae due to block in the first 72 h after surgery.https://www.mdpi.com/2077-0383/11/9/2646anesthesiaregional anesthesiapediatric anesthesiaadolescentparavertebral blockepidural anesthesia |
| spellingShingle | Emiliano Petrucci Franco Marinangeli Barbara Pizzi Francesco Sciorio Gioele Marrocco Massimo Antonio Innamorato Marco Cascella Alessandro Vittori A Modified Approach for Ultrasound-Guided Thoracic Paravertebral Block via Thoracic Intervertebral Foramen in an Adolescent Patient: A Case Report Journal of Clinical Medicine anesthesia regional anesthesia pediatric anesthesia adolescent paravertebral block epidural anesthesia |
| title | A Modified Approach for Ultrasound-Guided Thoracic Paravertebral Block via Thoracic Intervertebral Foramen in an Adolescent Patient: A Case Report |
| title_full | A Modified Approach for Ultrasound-Guided Thoracic Paravertebral Block via Thoracic Intervertebral Foramen in an Adolescent Patient: A Case Report |
| title_fullStr | A Modified Approach for Ultrasound-Guided Thoracic Paravertebral Block via Thoracic Intervertebral Foramen in an Adolescent Patient: A Case Report |
| title_full_unstemmed | A Modified Approach for Ultrasound-Guided Thoracic Paravertebral Block via Thoracic Intervertebral Foramen in an Adolescent Patient: A Case Report |
| title_short | A Modified Approach for Ultrasound-Guided Thoracic Paravertebral Block via Thoracic Intervertebral Foramen in an Adolescent Patient: A Case Report |
| title_sort | modified approach for ultrasound guided thoracic paravertebral block via thoracic intervertebral foramen in an adolescent patient a case report |
| topic | anesthesia regional anesthesia pediatric anesthesia adolescent paravertebral block epidural anesthesia |
| url | https://www.mdpi.com/2077-0383/11/9/2646 |
| work_keys_str_mv | AT emilianopetrucci amodifiedapproachforultrasoundguidedthoracicparavertebralblockviathoracicintervertebralforameninanadolescentpatientacasereport AT francomarinangeli amodifiedapproachforultrasoundguidedthoracicparavertebralblockviathoracicintervertebralforameninanadolescentpatientacasereport AT barbarapizzi amodifiedapproachforultrasoundguidedthoracicparavertebralblockviathoracicintervertebralforameninanadolescentpatientacasereport AT francescosciorio amodifiedapproachforultrasoundguidedthoracicparavertebralblockviathoracicintervertebralforameninanadolescentpatientacasereport AT gioelemarrocco amodifiedapproachforultrasoundguidedthoracicparavertebralblockviathoracicintervertebralforameninanadolescentpatientacasereport AT massimoantonioinnamorato amodifiedapproachforultrasoundguidedthoracicparavertebralblockviathoracicintervertebralforameninanadolescentpatientacasereport AT marcocascella amodifiedapproachforultrasoundguidedthoracicparavertebralblockviathoracicintervertebralforameninanadolescentpatientacasereport AT alessandrovittori amodifiedapproachforultrasoundguidedthoracicparavertebralblockviathoracicintervertebralforameninanadolescentpatientacasereport AT emilianopetrucci modifiedapproachforultrasoundguidedthoracicparavertebralblockviathoracicintervertebralforameninanadolescentpatientacasereport AT francomarinangeli modifiedapproachforultrasoundguidedthoracicparavertebralblockviathoracicintervertebralforameninanadolescentpatientacasereport AT barbarapizzi modifiedapproachforultrasoundguidedthoracicparavertebralblockviathoracicintervertebralforameninanadolescentpatientacasereport AT francescosciorio modifiedapproachforultrasoundguidedthoracicparavertebralblockviathoracicintervertebralforameninanadolescentpatientacasereport AT gioelemarrocco modifiedapproachforultrasoundguidedthoracicparavertebralblockviathoracicintervertebralforameninanadolescentpatientacasereport AT massimoantonioinnamorato modifiedapproachforultrasoundguidedthoracicparavertebralblockviathoracicintervertebralforameninanadolescentpatientacasereport AT marcocascella modifiedapproachforultrasoundguidedthoracicparavertebralblockviathoracicintervertebralforameninanadolescentpatientacasereport AT alessandrovittori modifiedapproachforultrasoundguidedthoracicparavertebralblockviathoracicintervertebralforameninanadolescentpatientacasereport |