EXTENDED UNILATERAL ANESTHESIA - NEW TECHNIQUE OR PARAVERTEBRAL ANESTHESIA

Background and Objectives. The authors previously reported a case in w hich injection of local anesthetic posterior to the endothoracic fasci a at the T11 vertebral level gave rise to extended analgesia in thorac ic and lumbar dermatomes. They now report a study in which this type o f anesthesia was used in patients undergoing herniorrhaphy. Methods. A 12-mL dose of 2% mepivacaine was injected at the T11 level posterior to the endothoracic fascia in 15 patients. Results. On average, seven dermatomes could be blocked with this dose and with a single injection . Nine patients experienced adequate analgesia and underwent operation with no additional sedation. In three patients the block resulted in inadequate analgesia, and additional sedative drugs were used. Three p atients experienced no analgesia and were given general anesthesia. Co nclusion. Injection of local anesthetic posterior to the endothoracic fascia resulted in extended unilateral anesthesia that was adequate fo r herniorrhaphy in 9 of the 15 patients (60%) studied.