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Extended unilateral anesthesia. New technique or paravertebral anesthesia?
T Saito1, E T Gallagher, S Cutler
1Department of Anesthesiology, Nippon Medical School, Tama-Nagayama Hospital, Tokyo, Japan.
Regional Anesthesia
|July 1, 1996
Summary
Local anesthetic injection posterior to the endothoracic fascia provided extended unilateral analgesia for herniorrhaphy in 60% of patients. This technique shows promise for surgical anesthesia, reducing the need for additional sedation.
Area of Science:
- Anesthesiology
- Surgical Procedures
Background:
- Previous case report indicated extended analgesia from local anesthetic injection posterior to the endothoracic fascia at T11.
- This technique targets thoracic and lumbar dermatomes for pain management.
Purpose of the Study:
- To evaluate the efficacy of local anesthetic injection posterior to the endothoracic fascia for patients undergoing herniorrhaphy.
- To determine the extent and adequacy of analgesia achieved with this method.
Main Methods:
- A 12-mL dose of 2% mepivacaine was administered via injection posterior to the endothoracic fascia at the T11 vertebral level.
- The study included 15 patients undergoing herniorrhaphy.
Main Results:
- A single injection blocked an average of seven dermatomes.
- Adequate analgesia for surgery was achieved in 9 out of 15 patients (60%), with no additional sedation required.
- Three patients required additional sedatives due to inadequate analgesia, and three required general anesthesia.
Conclusions:
- Injection of local anesthetic posterior to the endothoracic fascia can result in extended unilateral anesthesia.
- This technique was adequate for herniorrhaphy in 60% of the studied patients.
- Further research may optimize this approach for broader surgical applications.