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Transient Diaphragmatic Paralysis by Continuous Para-Phrenic Infusion of Bupivacaine: A Novel Technique for the Management of Residual Spaces  José M.

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Presentation on theme: "Transient Diaphragmatic Paralysis by Continuous Para-Phrenic Infusion of Bupivacaine: A Novel Technique for the Management of Residual Spaces  José M."— Presentation transcript:

1 Transient Diaphragmatic Paralysis by Continuous Para-Phrenic Infusion of Bupivacaine: A Novel Technique for the Management of Residual Spaces  José M. Clavero, MD, Juan E. Cheyre, MD, María E. Solovera, MD, Rodrigo P. Aparicio, MD  The Annals of Thoracic Surgery  Volume 83, Issue 3, Pages (March 2007) DOI: /j.athoracsur Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Epidural catheter positioned close to the phrenic nerve, the Tuohy needle has been withdrawn. An infusion bupivacaine 0.25% at 5 mL/h is started after surgery. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Postoperative chest roentgenogram of a 59-year-old woman with right malignant pleural effusion from non-Hodgkin lymphoma. Lung expansion after video-assisted thoracic surgery was incomplete and pleurodesis was postponed. Chest tube was kept on suction. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Chest roentgenogram of the same patient after second video-assisted thoracic surgical procedure with insertion of para-phrenic catheter and continuous infusion of bupivacaine. Note the significant elevation of the right hemi diaphragm and resolution of the space. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

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