Unilateral Thoracic Paravertebral Block for Effective Control of Pain : A Case Report of a Patient with Esophageal Cancer and Cirrhosis of the Liver.

We report a case in which unilateral thoracic para- vertebral block was used to effectively control pain in a 78-year-old male patient with Child's A liver cirrhosis and esophageal cancer. Epidural anesthesia was con- sidered risky in this case because of the low platelet count from cirrhosis....

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Bibliographic Details
Published inMasui. The Japanese journal of anesthesiology Vol. 65; no. 8; p. 832
Main Authors Iwata, Masato, Kimoto, Katsuhiro, Akasaki, Yuka, Morioka, Masayo, Nakayama, Kana, Matsuzawa, Nobuyoshi, Kuzumoto, Naoya, Shimomura, Toshiyuki
Format Journal Article
LanguageJapanese
Published Japan 01.09.2016
Subjects
Anesthesia, General
Catheterization
Esophageal Neoplasms - complications
Esophageal Neoplasms - surgery
Humans
Liver Cirrhosis - complications
Male
Middle Aged
Nerve Block - methods
Pain Management - methods
Pain, Postoperative - therapy
Thoracic Vertebrae
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Summary:We report a case in which unilateral thoracic para- vertebral block was used to effectively control pain in a 78-year-old male patient with Child's A liver cirrhosis and esophageal cancer. Epidural anesthesia was con- sidered risky in this case because of the low platelet count from cirrhosis. Therefore, we performed a unilat- eral thoracic paravertebral block and cannulation under general anesthesia. We administered 0.33% levobupi- vacaine 10 ml through the catheter for intraoperative analgesia. After the operation, we confirmed the place- ment of the catheter with a chest X-ray image : then, the patient was extubated and returned to the ward. Three hours after the operation, the patient com- plained of pain in his wound : hence, 0.33% levobupi- vacaine 5 ml was injected through the catheter, which effectively controlled pain for 10 hours. Further injec- tions were done 13 and 21 hours after the operation, and the catheter was removed 21 hours after the operation. While the catheter was in place, the patient scarcely complained of pain. The unilateral thoracic paravertebral block covered the wide range of wounds and provided good analgesia for the patient.
ISSN:0021-4892