Wiki pain management procedure - Left 8th rib ultrasound thoracic paravertebral nerve bloc

starryeyes1967

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Procedure: Left 8th rib ultrasound guided thoracic paravertebral nerve block.
Consent: Written consent was given after the risks, benefits, and alternatives of the procedure were explained and patient agreed to proceed with the injection. Indication for ultrasound guidance procedure includes obesity, better localization of intercostal nerve and less risk to patient of pneumothorax.
Description of Procedure: The patient was in the prone position for the procedure. After standard preparation with Chloraprep, the right 11th rib was prescanned posterolaterally, marked, and prepped. The associated intercostal vessels were clearly seen on ultrasound and avoided as well as the pleura just deep to the rib during injection using Sonosite M-Turbo with 15-6 MHz linear probe and injecting the kenalog 80mg with 1-1/2-inch 25-gauge needle with intermittent negative withdrawal of heme. Vascular structures were clearly seen and avoided. The needle was withdrawn. The patient tolerated the procedure well and there were no complications. The patient had immediate relief of symptoms. A sterile Band-Aid was applied. Postprocedure instructions were given. The pulse ox during and immediately after the procedure remained greater than 92% on RA.
 
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