Hrudní paravertebrální blokády – závislost meziobjemem aplikovaného roztoku a počtemzasažených nervových struktur (anatomická studie)

Thoracic Paravertebral Block: Relationship between Injected Volume and Number of AffectedNerve Structures (Anatomical Study)

Objective:
In last decade, thoracic paravertebral blocks have been increasingly used. As we use in our hospital a singleentry continuous paravetebral block for postoperative analgesia after thoracotomic procedures, we decided to investigatewhether a linear relationship exists between injected volume and extent of influenced intervertebral spaces.Design: Anatomical study on cadavers.Setting: Charles University, 3rd Medical School, University Hospital Kralovské Vinohrady, Prague.Material and methods:We performed an anatomical study on human adult cadavers by injecting water dyed with methyleneblue bilaterally at the level of Th 4. Using a standard technique, 10 ml of solution were injected in a prone position on oneside and 20 ml on the other side of the same cadaver. After removal of thoracic and abdominal organs methylene blue couldbe seen below the parietal pleura and the number of coloured intercostal spaces was determined.Results: Although 16 cadavers were used, bilateral block could be performed only in 12 cadavers because of anatomicaland technical problems. We demonstrated a relationship between injected volume and number of coloured intercostalspaces in each cadaver (P

Key words:
anaesthetic technique –⁠ local anaesthesia –⁠ paravertebral block –⁠ extent of block –⁠ anatomical study