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
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. (C) 2011 Elsevier Inc.
All rights reserved.
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