Why do paravertebral blocks?
Paravertebral blocks and decreased cancer recurrence
- BJA 2010 – Efficacy and Safety of Paravertebral Blocks in Breast Surgery: a meta-analysis of randomized clinical trials
- BJA 2010 – Effect of Anesthetic Technique and Other Perioperative Factors on Cancer Reccurence
- Anesthesiology 2006 – Can anesthetic technique for primary breast cancer surgery affect recurrence or metastasis?
- BJA 2012 – Can anesthetic and analgesic techniques affect cancer recurrence and risk?
- ASA: Paravertebral Block Ups Breast Cancer Surgery Outcomes
Paravertebral block techniques
- Anesthesiology News – Paravertebral Blocks: The Evolution of a Standard of Care
- YouTube Ultrasound-Guided Paravertebral Block
- NYSORA – Paravertebral Block: Landmark Technique
- Paravertebral Block Landmark Technique
- NYSORA – Paravetebral Block: Ultrasound-Guided Technique
But wait… what about the potential side effects/adverse events from a paravertebral block?
Why not do a TIVA with propofol and dexmetetomedine and local anesthesia via surgeon? Where’s that study to compare?
** Update ** July 20, 2016 –> What about the PEC 1&2 Blocks as well as Serratus block?
Prolonging blockade with adjuvants:
- IOSR J of Dental and Medical Sci; Dec 2015. Comparative study of bupiv with dexamethasone and bupi with clonidine through single space PVB for post op analgesia in thoracic and abdominal surgeries.
- 0.125% Bupiv + clonidine (1mcg/kg) vs 0.125% bupiv + dexamethasone (4mg): greater duration of analgesia in the dexamethasone group.