Thoracic paravertebral block in chronic postoperative pain.
OBJECTIVE
Chronic postoperative pain in thoracic dermatomes is common. The most frequently used methods of pain relief in this area are posterior multidermatomal intercostal nerve or thoracic epidural blocks. Compared with these methods, thoracic paravertebral block may have some advantages. Usually only one injection is needed, and the use of larger volumes of local anesthetic (up to 25 ml) results in widespread unilateral analgesia including sympathetic block without the potential risk of hypotension and motor block associated with epidural block.


METHODS
We retrospectively analyzed 281 thoracic paravertebral blocks performed for chronic postoperative pain (post-thoracotomy and postmastectomy) from 1986 to 1990 in our pain clinic.


RESULTS
In post-thoracotomy group, patients were without pain for at least a month after 58% of the blocks; in 30%, the effect lasted for at least two months; in 8%, more than four months and, in 3%, more than five months. In 88% of patients with postmastectomy pain, the achieved pain relief with thoracic paravertebral block was less than a month. No severe complications occurred.


CONCLUSIONS
Thoracic paravertebral block proved to be a reliable and safe technique for unilateral pain relief in chronic post-thoracotomy pain.
Kirvelä
O
O
Department of Anaesthesiology, Turku University Hospital, Finland.
Antila
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000009:adverse effects; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D011013:Pneumonectomy / Q000009:adverse effects; D011183:Postoperative Complications / Q000188:drug therapy; D012189:Retrospective Studies; D013127:Spinal Nerves