BILATERAL CONTINUOUS PARAVERTEBRAL BLOCK USED FOR POSTOPERATIVE ANALGESIA IN AN INFANT HAVING BILATERAL THORACOTOMY

We describe the successful postoperative pain management in an Ii-mont h-old infant who underwent bilateral thoracotomy, using continuous inf usions of bupivacaine into two directly placed paravertebral catheters . Haemodynamic parameters and pain scores were measured 1-2h for 60h w hile the infusions were continued and, intermittently blood samples we re taken for subsequent measurement of serum bupivacaine concentration s. The technique provided effective pain relief and the infant require d no other analgesia postoperatively. There were no adverse haemodynam ic consequences or complications relating to either catheter placement or drug infusions. Serum concentrations of bupivacaine remained below toxic levels throughout the study period, though accumulation did occ ur.