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Keep this study
Lead
University of Pittsburgh
The purpose of this project is to determine if there is a difference between paravertebral block performed with ultrasound assistance and paravertebral block performed with traditional technique in terms of twenty - four hour hydromorphone (dilaudid) consumption and visual analogue pain scores at rest or with deep breathing at twenty - four hours. This study will determine if ultrasound technique used for placement of paravertebral catheter facilitates safety of paravertebral catheterization and improves therapeutic effect of paravertebral blockade for pain control after thoracotomy. The investigators will also examine if ultrasound assisted paravertebral blockade improves pulmonary status in post-thoracotomy patient.
Age
18–75
Sex
ALL
Healthy volunteers
Not accepted
You may be eligible if
1\. American Society of Anesthesiologists (ASA) I-III subjects
2\. Ages 18-75 years
3\. BMI \< 40
4\. Scheduled for elective thoracic surgery at University of Pittsburgh Medical Center (UPMC) Passavant and Shadyside Hospitals in Pittsburgh, Pennsylvania
5\. Patients willing and able to provide informed consent
You may not be if
1\) Age younger than 18 years or older than 75 years
(2) Any contraindication to the placement of unilateral thoracic paravertebral catheter, including local infection, hypocoagulable state.
(3) American Society of Anesthesiologists physical status IV or greater
(4) chronic painful conditions
(5) preoperative opioid use
(6) coagulation abnormalities or patients who are expected to be on therapeutic anticoagulants postoperatively
(7) allergy to lidocaine, ropivacaine or bupivacaine
(8) personal or family history of malignant hyperthermia
(9) serum creatinine greater than 1.4 g/dl
(10) pregnancy or lactating.The pregnancy status will be determined by history and prior pregnancy testing when appropriate
(11) having an altered mental status (not oriented to place, person, or time) or emergency surgery
(12) comorbid conditions such as sepsis, unstable angina, congestive heart failure, moderate to severe valvular heart disease, severe chronic obstructive pulmonary disease (COPD)
(13) patient's inability to provide adequate informed consent
(14) patient refusal to nerve blocks and/or participation in the study
(15) respiratory support via ventilator post
(16) non English speaking
(17) allergy to contrast of iodine
(18) emergency surgery or any other non-elective procedure
(19) unstable vertebral and transverse process fractures