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Randomized Controlled Trial
. 2006 May-Jun;31(3):196-201.
doi: 10.1016/j.rapm.2005.12.004.

Thoracic paravertebral block: influence of the number of injections

Zoher M Naja  1 , Mariam El-Rajab, Mohamad A Al-Tannir, Fouad M Ziade, Khalil Tayara, Fadi Younes, Per-Arne Lönnqvist
Affiliations
Randomized Controlled Trial

Thoracic paravertebral block: influence of the number of injections

Zoher M Naja et al. Reg Anesth Pain Med. 2006 May-Jun.

Abstract

Background and objectives: The purpose of this study was to assess the radiographic and clinical distribution of 1 to 4 paravertebral injections by use of the same total volume of local anesthetic mixture.

Methods: Sixty-nine patients scheduled for surgical interventions suitable for bilateral PVB were included in the study and were randomly assigned to 1 of 3 treatment groups. Group 1 received 4 paravertebral injections on one side versus 1 injection on the contralateral side (23 patients), group 2 received 4 injections versus 2 injections (23 patients), and group 3 received 4 injections versus 3 injections (23 patients).

Results: Sixty-one patients were included in the final analysis, which resulted in 368 thoracic paravertebral injections. Overall, 97% of the patients had adequate loss of sensation within the targeted area at the side of 4 injections, compared with only 11% for the single injections. The average vertical spread of contrast was found to be significantly greater in the set of 4 injections, with mean (SD) 6.5 (2.01) dermatomes, compared with the single injection, with 3.0 (1.19) dermatomes (P < .05). The average vertical spread of contrast and complete absence of sensation were significantly greater in the set of 4 injections compared with the set of 2 and 3 injections (P < .05).

Conclusion: The main finding of the present study was that multiple paravertebral injections resulted in more reliable radiographic and clinical distribution compared with a single-injection technique.

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Comment in

  • Sleeping beauty or big bad wolf?
    Boezaart AP, Raw RM. Boezaart AP, et al. Reg Anesth Pain Med. 2006 May-Jun;31(3):189-91. doi: 10.1016/j.rapm.2006.02.002. Reg Anesth Pain Med. 2006. PMID: 16701180 No abstract available.

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