|| DukeMedNews || Paravertebral Block for Surgery

Background: In cases when patients have significant illnesses, anesthesiologists perform a procedure that blocks pain to a specific region, not systemically as a general anesthetic does. Called a paravertebral block, a series of injections are made to numb the nerves that emerge from the spinal cord to supply the chest area. The block doesn’t affect overall lung or heart functioning and because blood flow is low in the area injected with the paravertebral block, anesthetic is absorbed slowly and pain relief lasts for up to an astonishing 30 hours, during which the body has started to recover.

The procedure was first used at Duke in 1995. To date, more than 200 patients at Duke have had the block, and now 80 percent of women undergoing the surgery choose the new technique. Of these, about one-third choose to go home within hours of their operation. A preliminary report, published in 1995 in the Annals of Surgery that detailed Duke’s initial experience using the block on 15 patients, said that the block provided pain relief for the patients for an average of 23 hours, and 10 of the women elected to go home the same day of the surgery. In all, “the most meaningful aspect of this initial experience with paravertebral blocks has been patient satisfaction,” the doctors concluded. They now are conducting a much larger, 150-patient prospective, randomized clinical trial comparing paravertebral block to general anesthesia.

Word has quietly spread about the success of the block, which is now being practiced in a handful of hospitals, from Georgetown Medical Center to one in Ireland. Anesthesiologists at Duke are training more and more doctors in its use.

Suggested lead: For reasons that doctors don’t fully understand, women who receive general anesthesia for breast cancer surgery suffer severe side-effects. At Duke University Medical Center, doctors are trying a new technique for these patients and are pleased with the results. Melinda Stubbee describes the experience of woman who gone through the procedure both ways.

SOQ…:60

In Cut 1, Loy says being one of the first women to be injected with the block was a positive experience and one she would recommend to others.

Cut 1…much better…:23
(Preview this in a AIFF or WAV file in 8 bit mono. For the full interview in high quality ISDN sound, call the newsline.)

Loy says the second time she had breast cancer surgery she decided to take the “easy way out” by just “going to sleep” under general anesthesia.. She says it was horrible, and she suffered severe nausea. In Cut 2, she says the block was much better.

Cut 2…much better…:10
(Preview this in a AIFF or WAV file in 8 bit mono. For the full interview in high quality ISDN sound, call the newsline.)