Paravertebral blockade using a catheter implanted under visual control during thoracosurgical procedure as an ideal expedient for treating postoperative pain
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Clinical Department of Thoracic Surgery, Municipal Hospital in Olsztyn, Poland
Grzegorz Kulesza   

Clinical Department of Thoracic Surgery, Municipal Hospital in Olsztyn, Niepodległości 44, 10-045 Olsztyn, Poland. Tel.: +4889 532 33 57.
Submission date: 2017-03-18
Acceptance date: 2017-10-14
Online publication date: 2018-02-05
Publication date: 2019-11-17
Pol. Ann. Med. 2018;25(1):153–157
Postoperative pain is a natural occurrence after surgery, and its severity significantly affects the overall condition and likely recovery time of the patient. Because postoperative thoracic pain is one of the most severe postoperative, the physician must repeatedly administer medication from all levels of painkillers. Use may involve potential risks of further complications.

The aim is to describe some pathophysiological aspects of pain, some methods of pain therapy, anatomy of paravertebral space (PVS) and methods of performing a paravertebral blockade, especially the implementation of a catheter to the PVS, during operation from lateroposterial access.

Material and methods:
This work was based on the available literature and the experience of the authors.

Results and discussion:
This method was implemented on 38 patients over a 10 month span. On 3 of the patients, the analgesic effect was not obtained. In the author’s opinion this was due to the intercostal being opened too wide with the same PVS resulting in the administered medication reaching the pleura, hence not making the desired impact. On the remaining patients the analgesic effect was obtained at a level of 3–5 PVS, without the necessity of administrating opioids in the case of breakthrough pain. After the first 24 h following surgical procedure the patients showed positive signs of recovery and were able to start rehabilitation.

Intraoperatively implanting a catheter to the PVS following thoracosurgical procedure in order to conduct continuous, regional postoperative anaesthesia is a safe and effective method of treating postoperative pain in thoracic surgery.

None declared.
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