T1, T2 paraverterbal blocks provide opioid sparing in first rib resection for thoracic outlet syndrome

Thoracic outlet syndrome (TOS) is caused by compression of one or more of the 3 neurovascular structures between the first rib and clavicle: the brachial plexus, subclavian vein, or subclavian artery [1]. When conservative treatments fail, surgical intervention may be the only option, i.e. first rib resection (FRR) [1,2]. Cervical-thoracic PVB has been incorporated into the anesthetic regimen by previous authors to better manage postoperative pain and minimize opioid use [3]. While thoracic PVBs are effective for post-thoracotomy pain [4], existing literature is limited and there is no current description of its use for FRR.
Source: Journal of Clinical Anesthesia - Category: Anesthesiology Authors: Tags: Correspondence Source Type: research