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Regional Techniques for Thoracic Wall Surgery

  • Regional Anesthesia (CJL McCartney, Section Editor)
  • Published:
Current Anesthesiology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Regional anesthesia of the thoracic wall has rapidly progressed with refinement of existing techniques and the evolution of novel fascial plane techniques. This article aims to provide a narrative review of the key advancements in the last 5 years.

Recent Findings

Noteworthy developments include ultrasonography for the performance of thoracic epidural and paravertebral blockade, evidence indicating that thoracic paravertebral blockade carries similar analgesic efficacy to thoracic epidural analgesia, but with a superior side effect profile, and the description of multiple novel fascial plane techniques, including paraspinal thoracic plane blocks, intercostal-paraspinal plane blocks, the pectoral blocks, and the serratus plane block.

Summary

Ultrasound continues to change the practice of regional anesthesia, with integration into time-honored techniques such as epidural or paravertebral blockade. The established gold standard—the thoracic epidural—is being challenged, with a move towards paravertebral blockade. Fascial plane blocks hold promise for the future, but require further clinical trials for validation.

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Authors and Affiliations

  1. Toronto Western Hospital, Toronto, ON, Canada

    Kim Wild & Ki Jinn Chin

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  1. Kim Wild
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Correspondence to Ki Jinn Chin.

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Kim Wild and Ki Jinn Chin declare they have no conflict of interest.

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All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki Declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).

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This article is part of the Topical Collection on Regional Anesthesia

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Wild, K., Chin, K.J. Regional Techniques for Thoracic Wall Surgery. Curr Anesthesiol Rep 7, 212–219 (2017). https://doi.org/10.1007/s40140-017-0212-y

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