Article Text

  1. C. E. Monroe,
  2. C. A. Heinrich,
  3. L. Wat,
  4. S. Gupta*
  1. Loma Linda University, Loma Linda, CA
  2. *Division of Plastic Surgery, Loma Linda University, Loma Linda, CA


Purpose Bilateral paravertebral block (PVB) is an anesthetic method that anesthetizes the intervertebral nerves as they exit the intervertebral foramina by single-injection or a continuous catheter technique. The technique was originally used in abdominal surgery by Hugo Sellhiem in early 1919. However, it remained relatively unused until its resurrection by Eason and Wyatt in 1979 and its application to ambulatory care by Wood in 1981. Since its employment in breast cancer surgery by Weltz in 1995, PVB has been used as the primary method of anesthesia or as an adjunct analgesic in breast surgery procedures. Bilateral PVB provides an alternative in care for breast surgery patients due to its ability to decrease pain and postoperative nausea and vomiting (PONV). A retrospective study of patients undergoing primary augmentation and mastopexy augmentation was done to compare outcomes of those patients that received bilateral PVBs to those that received intraoperative local anesthesia.

Methods The charts of primary breast augmentation and augmentation mastopexy patients that received either bilateral PVBs or intraoperative local anesthesia were reviewed. The end points chosen for comparison were the amount of narcotics used intraoperatively and in the recovery room, the length of time in the recovery room, and the number of antiemetics given.

Results Preliminary data show that the patients who received bilateral PVB as their anesthetic method used less narcotics intraoperatively and postoperatively as well as less antiemetics when compared with patients that received intraoperative local anesthetic.

Conclusions Bilateral PVBs appear to decrease intraoperative and postoperative narcotic and antiemetic use when compared to intraoperative local anesthesia. Further prospective studies will be conducted to assess the use of bilateral PVBs as primary anesthesia.

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