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Waveform characteristics in thoracic paravertebral space: a prospective observational study
Amorn Vijitpavan1, Sivaporn Termpornlert1, Pattika Subsoontorn1
1Department of Anesthesiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Ratchathewi, Bangkok, 10400, Thailand.
Ultrasound and pressure waveform analysis reliably identify the thoracic paravertebral space (TPVS) for thoracic paravertebral block (TPVB). This method offers high sensitivity for accurate needle placement in thoracic surgery anesthesia.
Area of Science:
- Anesthesiology
- Thoracic Surgery
- Ultrasound Guidance
Background:
- Thoracic paravertebral block (TPVB) is increasingly used in thoracic surgery.
- Accurate ultrasonographic localization of the thoracic paravertebral space (TPVS) remains a challenge.
- This study investigates TPVS characteristics during anesthesia.
Purpose of the Study:
- To investigate the waveform characteristics and pressure values within the TPVS.
- To assess the utility of combined ultrasound and pressure waveform analysis for TPVS identification.
- To evaluate factors influencing TPVS waveform characteristics.
Main Methods:
- Observational study of 50 patients undergoing elective lung surgery.
- TPVB performed at T4/5 and T6/7 using ultrasound guidance.
- Pressure transducer system connected to needle hub to measure pressure and waveform in multiple locations.
Main Results:
- Typical regular respiratory waveforms with mean pressure ≤ 25 mmHg detected in TPVS.
- Combined ultrasound and pressure waveform technique showed 95.45% sensitivity for TPVS identification.
- Previous thoracic surgery was a factor interfering with waveform characteristics.
Conclusions:
- The TPVS exhibits low pressure with a smooth, regular respiratory waveform.
- This pressure waveform pattern aids in identifying the TPVS during TPVB.
- The findings support the use of pressure waveform analysis for improved TPVS localization.
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