Kim Jeongsoo, Lee Ho-Jin, Lee Young-Ju, Lee Chang-Soon, Yoo Yongjae, Moon Jee Youn
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
J Pain Res. 2020 Dec 14;13:3395-3403. doi: 10.2147/JPR.S285998. eCollection 2020.
Ultrasound-guided thoracic paravertebral block (US-TPVB) is considered a treatment option for the management of acute pain in various pain-related conditions. We conducted a prospective pilot study to evaluate the possibility of US-TPVB as a sympathetic blockade in patients with neuropathic pain disorders in the upper extremities.
A total of 12 patients underwent US-TPVB between the T2 and T3 paravertebral space with 10 mL of 1% mepivacaine. The temperature change (°C) before and after the procedure was compared between the ipsilateral and contralateral hands. We counted the proportion of patients showing a temperature increase ≥1.5°C and compared a change in the pain intensity before and after the procedure.
The median increase in the temperature change between the ipsilateral and contralateral hands was 1.54°C (interquartile range, 1.28-2.20). There were seven patients (58.3%) who showed a temperature difference ≥1.5°C between both hands after the US-TPVB. Eleven patients (91.7%) reported a reduction in pain according to the score on the 11-point numerical rating scale. No serious complications relevant to the procedure were reported.
US-TPVB could be a useful technique for sympathetic blockade in patients with upper extremity pain.
超声引导下胸椎旁神经阻滞（US - TPVB）被认为是治疗各种疼痛相关疾病中急性疼痛的一种选择。我们进行了一项前瞻性试点研究，以评估US - TPVB作为上肢神经性疼痛障碍患者交感神经阻滞的可能性。
共有12例患者在T2和T3椎旁间隙接受了US - TPVB，注射10 mL 1%的甲哌卡因。比较手术前后同侧和对侧手部的温度变化（°C）。我们统计了温度升高≥1.5°C的患者比例，并比较了手术前后疼痛强度的变化。
同侧和对侧手部温度变化的中位数升高为1.54°C（四分位间距，1.28 - 2.20）。有7例患者（58.3%）在US - TPVB后双手之间的温度差≥1.5°C。根据11点数字评分量表评分，11例患者（91.7%）报告疼痛减轻。未报告与该手术相关的严重并发症。
US - TPVB可能是上肢疼痛患者交感神经阻滞的一种有用技术。
