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Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
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[Multiple-injection thoracic paravertebral block for reconstructive breast surgery].

L A Sopena-Zubiria¹, L A Fernández-Meré, F Muñoz González

¹Hospital Universitario Central de Asturias (HUCA), Centro Residencia Covadonga, Oviedo. lasz1957@yahoo.es

Revista Espanola De Anestesiologia Y Reanimacion

|July 22, 2010

Summary

Multiple-injection thoracic paravertebral blockade is an effective anesthesia technique for breast reconstruction. This method, blocking dermatomes T3-5, offers good pain control and high patient satisfaction with minimal complications.

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Area of Science:

Anesthesiology
Surgical Anesthesia

Background:

Reconstructive breast surgery requires effective anesthesia.
Thoracic paravertebral blockade is an alternative anesthetic technique.

Purpose of the Study:

To evaluate the efficacy and safety of multiple-injection thoracic paravertebral blockade for reconstructive breast surgery.
To assess patient satisfaction with this anesthetic technique.

Main Methods:

A prospective study of 100 patients undergoing reconstructive breast surgery.
Triple-injection paravertebral block targeting T3-5 dermatomes with intravenous sedation.
Data collection included procedure time, block onset, effectiveness, complications, and patient satisfaction.

Main Results:

Successful T3-5 dermatome blockade in 99% of patients.
Average procedure time was 7.39 minutes with 7.37 minutes latency.
High patient satisfaction (91%) with adequate postoperative analgesia and low complication rates (e.g., no pneumothorax).

Conclusions:

Triple-injection thoracic paravertebral blockade is an effective, easily performed anesthetic technique for breast reconstruction.
The technique is associated with a high degree of patient satisfaction and a low incidence of complications.
This method provides effective anesthesia and analgesia for reconstructive breast surgery.