DOI QR코드

DOI QR Code

Ultrasound-guided Aspiration of the Iatrogenic Pneumothorax Caused by Paravertebral Block -A Case Report-

  • Park, Jin-Suk (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea) ;
  • Kim, Young-Hoon (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea) ;
  • Jeong, Su-Ah (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea) ;
  • Moon, Dong-Eon (Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea)
  • Received : 2011.11.14
  • Accepted : 2011.11.23
  • Published : 2012.01.01

Abstract

Thoracic paravertebral block is performed for the treatment of patients with chronic pain, such as complex regional pain syndrome (CRPS) and post-herpetic neuralgia. Thoracic paravertebral block can result in iatrogenic pneumothorax. Because pneumothorax can develop into medical emergencies and needle aspiration or chest tube placement may be needed, early diagnosis is very important. Recently, thoracic ultrasonography has begun to be used to diagnose pneumothorax. In addition, ultrasound-guided aspiration can be an accurate and safe technique for treatment of pneumothorax, as the needle position can be followed in real time. We report a case of iatrogenic pneumothorax following thoracic paravertebral block for the treatment of chronic pain due to CRPS, treated successfully by ultrasound-guided aspiration.

Keywords

References

  1. Lonnqvist PA, MacKenzie J, Soni AK, Conacher ID. Paravertebral blockade. Failure rate and complications. Anaesthesia 1995; 50: 813-5.
  2. Alrajhi K, Woo MY, Vaillancourt C. Test characteristics of ultrasonography for the detection of pneumothorax: a systematic review and meta-analysis. Chest [serial on the Internet]. 2011 Aug [2011 Aug 25]. Available at http://chestjournal.chestpubs.org/content/early/2011/08/24/chest.11-0131.
  3. Lichtenstein DA, Meziere G, Lascols N, Biderman P, Courret JP, Gepner A, et al. Ultrasound diagnosis of occult pneumothorax. Crit Care Med 2005; 33: 1231-8.
  4. Novak-Jankovic V. Update on thoracic paravertebral blocks. Coll Antropol 2011; 35: 595-8.
  5. Medford AR, Entwisle JJ. Indications for thoracic ultrasound in chest medicine: an observational study. Postgrad Med J 2010; 86: 8-11.
  6. Lichtenstein D, Meziere G, Biderman P, Gepner A. The comet-tail artifact: an ultrasound sign ruling out pneumothorax. Intensive Care Med 1999; 25: 383-8.
  7. Lichtenstein DA, Menu Y. A bedside ultrasound sign ruling out pneumothorax in the critically ill. Lung sliding. Chest 1995; 108: 1345-8.
  8. Rowan KR, Kirkpatrick AW, Liu D, Forkheim KE, Mayo JR, Nicolaou S. Traumatic pneumothorax detection with thoracic US: correlation with chest radiography and CT--initial experience. Radiology 2002; 225: 210-4.
  9. Yang SY, Sung CH, Yoon KJ, Kim SH, Moon SW, Moon DE. Iatrogenic pneumothorax after thoracic paravertebral block: a report of 2 cases. J Korean Pain Soc 2003; 16: 273-7.
  10. Laub M, Milman N, Muller D, Struve-Christensen E. Role of small calibre chest tube drainage for iatrogenic pneumothorax. Thorax 1990; 45: 748-9.

Cited by

  1. Ultrasound Sonography at the Pain Clinic in Korea: Past, Present and Future vol.26, pp.1, 2013, https://doi.org/10.3344/kjp.2013.26.1.1
  2. Thoracic paravertebral blockade in breast surgery: Is pneumothorax an appreciable concern? A review of over 1000 cases pp.1075122X, 2017, https://doi.org/10.1111/tbj.12831
  3. Ultrasound-guided erector spinae plane block versus oblique subcostal transversus abdominis plane block for postoperative analgesia of adult patients undergoing laparoscopic cholecystectomy: Randomize vol.57, pp.None, 2012, https://doi.org/10.1016/j.jclinane.2019.03.012