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. 2020 Jul;62(1):70-75.
doi: 10.1002/mus.26894. Epub 2020 Apr 28.

Paravertebral block for radiologically inserted gastrostomy tube placement in amyotrophic lateral sclerosis

Steven B Porter  1 , Robert L McClain  1 , Christopher B Robards  1 , Ricardo Paz-Fumagalli  2 , Steven R Clendenen  1 , Ilana I Logvinov  1 , Karina O Hex  1 , Carla Palmucci  3 , Björn E Oskarsson  3
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Paravertebral block for radiologically inserted gastrostomy tube placement in amyotrophic lateral sclerosis

Steven B Porter et al. Muscle Nerve. 2020 Jul.

Abstract

Introduction: Radiologically inserted gastrostomy (RIG) placement in patients with amyotrophic lateral sclerosis (ALS) carries risks related to periprocedural sedation and analgesia. To minimize these risks, we used a paravertebral block (PVB) technique for RIG placement.

Methods: We retrospectively reviewed patients with ALS undergoing RIG placement under PVB between 2013 and 2017.

Results: Ninety-nine patients with ALS underwent RIG placement under PVB. Median (range) age was 66 (28 to 86) years, ALS Functional Rating Scale-Revised score was 27 (6 to 45), and forced vital capacity was 47% (8%-79%) at time of RIG placement. Eighty-five (85.9%) patients underwent RIG placement as outpatients, with a mean postanesthesia care unit stay of 2.3 hours. The readmission rate was 4% at both 1 and 30 days postprocedure.

Discussion: PVB for RIG placement has a low rate of adverse events and provides effective periprocedural analgesia in patients with ALS, the majority of whom can be treated as outpatients.

Keywords: amyotrophic lateral sclerosis; analgesia; anesthesia; gastrostomy tube; paravertebral block; radiologically inserted gastrostomy.

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References

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