engleski

Thoracic paravertebral nerve block as the sole anesthetic for an open biopsy of a large anterior mediastinal mass

There is a nearly infinite list of cases that can be performed under thoracic paravertebral nerve block but its use as the sole anesthetic for an open biopsy of a large anterior mediastinal mass has not been reported before. A 32-year-old woman was scheduled for an anterior mediastinotomy and open biopsy of a superior and middle anterior mediastinal tumor. Large blood vessels and the whole heart were embedded in the tumor and the left main bronchus was significantly compressed and the trachea was displaced to the right. Considering that in such high risk patient general anesthesia should be avoided and local anesthesia is not sufficient, we used thoracic paravertebral block repeated at each dermatome level. The biopsy specimen was inadequate for histopathological analysis, and the procedure had to be repeated also under thoracic paravertebral nerve block. The patient was awake for the duration of the surgery, did not experience any pain, and remained circulatory and respiratory stable. The use of a thoracic paravertebral block as the sole anesthetic for anterior mediastinotomy and open biopsies of an anterior mediastinal mass resulted in adequate unilateral anesthesia.

thoracic paravertebral nerve block; anesthesia; analgesia; mediastinotomy; thoracic surgery; thoracic anesthesia

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