title: Bilateral continuous paravertebral block used for postoperative analgesia in an infant having bilateral thoracotomy.
abstract: We describe the successful postoperative pain management in an 11-month-old infant who underwent bilateral thoracotomy, using continuous infusions of bupivacaine into two directly placed paravertebral catheters. Haemodynamic parameters and pain scores were measured 1-2 h for 60 h while the infusions were continued and, intermittently, blood samples were taken for subsequent measurement of serum bupivacaine concentrations. The technique provided effective pain relief and the infant required no other analgesia postoperatively. There were no adverse haemodynamic consequences or complications relating to either catheter placement or drug infusions. Serum concentrations of bupivacaine remained below toxic levels throughout the study period, though accumulation did occur.
authors.affiliation: Royal Liverpool Children's NHS Trust, UK.
authors.forename: M K
authors.initials: MK
authors.lastname: Karmakar
authors.forename: P D
authors.initials: PD
authors.lastname: Booker
authors.forename: R
authors.initials: R
authors.lastname: Franks
mesh_terms: D000698:Analgesia / Q000379:methods*; D000775:Anesthesia, Spinal; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D001011:Aorta / Q000002:abnormalities / Q000601:surgery; D016121:Brachiocephalic Veins / Q000002:abnormalities / Q000601:surgery; D002045:Bupivacaine / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D002404:Catheterization / Q000295:instrumentation; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007223:Infant; D007267:Injections / Q000295:instrumentation; D008297:Male; D009407:Nerve Block; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D011651:Pulmonary Artery / Q000002:abnormalities / Q000601:surgery; D011667:Pulmonary Veins / Q000002:abnormalities / Q000601:surgery; D013908:Thoracotomy / Q000009:adverse effects / Q000379:methods*
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine