Possibilities of using paravertebral blockade in laparoscopic kidney surgery

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Abstract

A main goal of modern anesthesiology is to reduce the body’s stress response to surgical aggression. This needs a multidisciplinary approach: surgeons reduce the invasiveness of surgery, and anesthesiologists use a multimodal approach in the intraoperative and postoperative periods. They combine general anesthesia with epidural anesthesia (EA), which has not only undeniable and proven advantages but also several disadvantages. An interesting alternative is paravertebral block (PVB), a compromise between neuroaxial (EA) and peripheral nerve block. PVB provides analgesic efficacy comparable to that of EA, but with significantly fewer complications and side effects. Many studies have described the widespread and successful use of PVB in thoracic surgery and endoscopic urology. However, the literature on the use of PVB in laparoscopic renal surgery anesthesia is extremely scarce. Thus, large multicenter studies are needed to determine the place of PVB in the anesthetic management of laparoscopic renal surgery.

About the authors

Irina V. Lapkina

I.M. Sechenov First Moscow State Medical University

Author for correspondence.
Email: ilapkina81@mail.ru
ORCID iD: 0000-0001-8330-4146
SPIN-code: 1608-5127

anesthesiologist-resuscitator

Russian Federation, 8, Trubetskaya st., Moscow, 119991

Alexey M. Ovechkin

I.M. Sechenov First Moscow State Medical University

Email: ovechkin_alexei@mail.ru
ORCID iD: 0000-0002-3453-8699
SPIN-code: 1277-9220

MD, Dr. Sci. (Med.), professor

Russian Federation, Moscow

Tatyana M. Alekseeva

I.M. Sechenov First Moscow State Medical University

Email: altami62@rambler.ru
ORCID iD: 0000-0003-3560-873X
SPIN-code: 2644-4484

anesthesiologist-resuscitator

Russian Federation, Moscow

Roman I. Slusarenko

I.M. Sechenov First Moscow State Medical University

Email: slusarenco.roman@gmail.com
ORCID iD: 0000-0002-8111-9446
SPIN-code: 4051-0916

urologist

Russian Federation, Moscow

Evgenii A. Bezrukov

I.M. Sechenov First Moscow State Medical University

Email: eabezrukov@rambler.ru
ORCID iD: 0000-0002-2746-5962
SPIN-code: 2208-2676

MD, Dr. Sci. (Med.), professor

Russian Federation, Moscow

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Supplementary files

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2. Fig. Injection of an anesthetic into the paravertebral space. A) 1 – paravertebral space, 2 – vertebral body, 3 – transverse costal ligament, 4 – parietal pleura. B) Expansion of the paravertebral space is visualized, indicating successful administration of the drug

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