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Thoracic paravertebral block for implantable cardioverter-defibrillator and laser lead extraction
Tony Tsai1, Cesar Rodriguez-Diaz1, Bonnie Deschner1
1Department of Anesthesiology, Travers 701, St. Luke's-Roosevelt Hospital Center, New York, NY 10011; Columbia University College of Physicians and Surgeons, New York, NY 10025, USA.
Abstract:
Implantable cardioverter defibrillators (ICDs) are routinely placed in the cardiac electrophysiology laboratory. Previously, these procedures were performed in the operating room during general anesthesia. In recent years, electrophysiologists have been performing these procedures using local anesthetics in conjunction with intravenous sedation. We report a case in which thoracic paravertebral blocks with mild sedation were successful for infected ICD and laser lead extraction. Randomized, controlled trials are required to determine whether thoracic paravertebral block with sedation is more effective than local anesthesia with sedation in providing adequate anesthesia for ICD placement and extraction.
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