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KMID : 1155520230180020198
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Anesthesia and Pain Medicine
2023 Volume.18 No. 2 p.198 ~ p.203
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Bolus intertransverse process block and continuous erector spinae plane block for perioperative analgesic management of video-assisted thoracoscopic surgery - Three cases report --
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Yuki Yamamoto
Nobuhiro Tanaka
Yuma Kadoya
Miki Umehara
Takanori Suzuka
Masahiko Kawaguchi
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Abstract
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Background: Common regional anesthesia approaches for video-assisted thoracoscopic surgery (VATS) include paravertebral block (PVB) and erector spinae plane block (ESPB). PVB is considered a deep nerve block which is contraindicated in antithrombotic therapy. ESPB is effective when administered as a bolus, as well as continuously. However, the recently proposed intertransverse process block (ITPB) ensures more effective diffusion of the local anesthetic into the paravertebral space.
Case: We report cases of three patients who received bolus ITPB (costotransverse foramen block and mid-point transverse process-to-pleura block in one and two cases, respectively) combined with continuous ESPB when a deep nerve block could not be administered. Opioids were not required postoperatively, and all postoperative numerical rating scale scores (0?10) at rest were maintained below 4.
Conclusions: The combination of bolus ITPB and continuous ESPB may be an alternative analgesic method when deep nerve blocks are contraindicated in VATS.
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KEYWORD
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Analgesia, Anesthesia, Regional anesthesia, Video-assisted thoracoscopic surgery
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