TY - JOUR
T1 - The paravertebral lamina technique
T2 - A new regional anesthesia approach for breast surgery
AU - Jüttner, Tobias
AU - Werdehausen, Robert
AU - Hermanns, Henning
AU - Monaca, Enrico
AU - Danzeisen, Oliver
AU - Pannen, Benedikt H.
AU - Janni, Wolfgang
AU - Winterhalter, Michael
PY - 2011/9
Y1 - 2011/9
N2 - Study Objective: To test the feasibility and efficacy of a new approach to paravertebral catheter placement in patients undergoing major surgery of the breast. Design: Single-group, single-center observational study. Setting: Operating room, postoperative recovery area, and normal ward of a university hospital. Patients: 25 ASA physical status 1, 2, 3, and 4 patients undergoing major unilateral surgery of the breast. Interventions: Paravertebral catheters for intraoperative and postoperative anesthesia and analgesia were applied using the recently described lamina technique. This technique is performed at a more medial puncture site, avoiding the pleura. Measurements: Additional opioid requirements were recorded to assess effectiveness of regional anesthesia. At the time of catheter withdrawal, patients, staff nurses, and anesthesiologists who provided postoperative pain management were asked to rate their satisfaction with paravertebral catheter effectiveness. Main Results: All patients successfully received a paravertebral catheter using the lamina technique. During the surgical procedure, 84% of patients received no additional opioids after intubation. No patient required opioids as rescue medication postoperatively (visual analog scale rating > 30mm) or during the rest of the hospital stay. Postoperative analgesia provided with paravertebral catheters was rated very high by patients, staff nurses, and anesthesiologists involved in postoperative care. Conclusions: The lamina technique for placement of a paravertebral catheter is a feasible and effective technique for intraoperative and postoperative analgesia in patients scheduled for major breast surgery with or without axillary lymph node resection.
AB - Study Objective: To test the feasibility and efficacy of a new approach to paravertebral catheter placement in patients undergoing major surgery of the breast. Design: Single-group, single-center observational study. Setting: Operating room, postoperative recovery area, and normal ward of a university hospital. Patients: 25 ASA physical status 1, 2, 3, and 4 patients undergoing major unilateral surgery of the breast. Interventions: Paravertebral catheters for intraoperative and postoperative anesthesia and analgesia were applied using the recently described lamina technique. This technique is performed at a more medial puncture site, avoiding the pleura. Measurements: Additional opioid requirements were recorded to assess effectiveness of regional anesthesia. At the time of catheter withdrawal, patients, staff nurses, and anesthesiologists who provided postoperative pain management were asked to rate their satisfaction with paravertebral catheter effectiveness. Main Results: All patients successfully received a paravertebral catheter using the lamina technique. During the surgical procedure, 84% of patients received no additional opioids after intubation. No patient required opioids as rescue medication postoperatively (visual analog scale rating > 30mm) or during the rest of the hospital stay. Postoperative analgesia provided with paravertebral catheters was rated very high by patients, staff nurses, and anesthesiologists involved in postoperative care. Conclusions: The lamina technique for placement of a paravertebral catheter is a feasible and effective technique for intraoperative and postoperative analgesia in patients scheduled for major breast surgery with or without axillary lymph node resection.
KW - Anesthesia, regional
KW - Anesthetic techniques: nerve block, paravertebral nerve block
KW - Intraoperative care
KW - Mastectomy
KW - Perioperative care
KW - Postoperative care
UR - http://www.scopus.com/inward/record.url?scp=80052781443&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jclinane.2010.12.015
DO - https://doi.org/10.1016/j.jclinane.2010.12.015
M3 - Article
C2 - 21752620
SN - 0952-8180
VL - 23
SP - 443
EP - 450
JO - Journal of Clinical Anesthesia
JF - Journal of Clinical Anesthesia
IS - 6
ER -