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Pulmonary haemorrhage after percutaneous paravertebral block
P W Thomas1, D J Sanders, R G Berrisford
1Department of Anaesthesia, Royal Devon and Exeter Hospital, UK.
British Journal of Anaesthesia
|February 16, 2000
Summary
A rare complication of percutaneous paravertebral block, pulmonary hemorrhage, occurred in a patient undergoing thoracotomy. Adhesions and fibrosis were noted, questioning the safety of this analgesic technique.
Area of Science:
- Anesthesiology
- Thoracic Surgery
- Pain Management
Background:
- Percutaneous paravertebral block is a regional anesthesia technique.
- It is often used for pre-emptive analgesia before thoracic surgery.
- The loss of resistance to saline technique is a common method for needle placement.
Observation:
- A 65-year-old woman developed pulmonary hemorrhage post-percutaneous paravertebral injection.
- The patient was undergoing anesthesia for thoracotomy.
- Previous surgery had resulted in adhesions and fibrosis in the paravertebral space.
Findings:
- Pulmonary hemorrhage is a previously unreported complication of percutaneous paravertebral block.
- Lung tissue was found adhered to the chest wall during thoracotomy.
- The paravertebral space was fibrosed due to prior surgical interventions.
Implications:
- This case highlights a potential risk associated with percutaneous paravertebral blocks.
- The findings necessitate a re-evaluation of the risk-benefit ratio for this analgesic approach.
- Further research is needed to understand and mitigate this rare complication.