Skip to main content

Pneumothorax After Paravertebral Block and Radiofrequency

  • Chapter
  • First Online:
Challenging Cases and Complication Management in Pain Medicine

Abstract

Chest wall pain is a common complaint after thoracic and chest wall surgery, radiation, and tumor invasion, with significant impact on patients and the healthcare system. If left unmanaged, chest wall pain can significantly impair quality of life. Detection and diagnosis are paramount to management and recovery. Chronic pain also is highly prevalent after breast surgery and thoracotomy. Although many therapies may reduce chest wall pain, a comprehensive treatment plan incorporating potent and targeted interventions may relieve pain and restore function. Chest wall procedures carry several specific risks unique to thoracic anatomy. In this chapter, we explore these risks and present a case of pneumothorax after paravertebral radiofrequency ablation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Weksler N, Klein M, Gurevitch B, et al. Phenol neurolysis for severe chronic nonmalignant pain: is the old also obsolete? Pain Med. 2007;8(4):332–7.

    Article  PubMed  Google Scholar 

  2. Vila H, Liu J, Kavasmaneck D. Paravertebral block: new benefits from an old procedure. Curr Opin Anesthesiol. 2007;20:316–8.

    Article  Google Scholar 

  3. Belfer I, Schreiber KL, Shaffer JR, et al. Persistent postmastectomy pain in breast cancer survivors: analysis of clinical, demographic, and psychosocial factors. J Pain. 2013;14:1185–95.

    Article  PubMed  Google Scholar 

  4. Peng Z, Li H, Qian X, et al. A retrospective study of chronic post-surgical pain following thoracic surgery: prevalence, risk factors, incidence of neuropathic component, and impact on quality of life. PLoS One. 2014;92:e90014.

    Article  Google Scholar 

  5. Kehlet H, Jensen T, Woolf C. Persistent postsurgical pain: risk factors and prevention. Lancet. 2006;367:1618–25.

    Article  PubMed  Google Scholar 

  6. Enck R. Postsurgical chronic pain. Am J Hosp Palliat Care. 2010;27:301–2.

    Article  PubMed  Google Scholar 

  7. Gulati A, et al. A retrospective review and treatment paradigm of interventional therapies for patients suffering from intractable thoracic chest wall pain in the oncologic population. Pain Med. 2015;16:802–10.

    Article  PubMed  Google Scholar 

  8. Andreae M, Andreae D. Local anesthetics and regional anesthesia in preventing chronic pain after surgery. Cochrane Database Syst Rev. 2012;10:CD007105.

    PubMed  PubMed Central  Google Scholar 

  9. Wardhan R. Update on paravertebral blocks. Curr Opin Anesthesiol. 2015;28:588–92.

    Article  CAS  Google Scholar 

  10. Sloan P. The evolving role of interventional pain management in oncology. J Support Oncol. 2004;2(6):491–500. 503

    PubMed  Google Scholar 

  11. Gollapalli L, Muppuri R. Paraplegia after intercostal neurolysis with phenol. J Pain Res. 2014;7:665–8.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Kim B, No M, Han S, et al. Paraplegia following intercostal nerve neurolysis with alcohol and thoracic epidural injection in lung cancer patients. Korean J Pain. 2015;28:148–52.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Cohen S, Sireci A, Wu C, et al. Pulse radiofrequency of the dorsal root ganglia is superior to pharmacotherapy or pulsed radiofrequency of the intercostal nerves in the treatment of chronic postsurgical thoracic pain. Pain Physician. 2006;9:227–36.

    PubMed  Google Scholar 

  14. Akkaya T, Ozkan D. Ultrasound-guided pulsed radiofrequency treatment of the intercostal nerve: three cases. J Anesth. 2013;27:968–9.

    Article  PubMed  Google Scholar 

  15. Zanogoulidis P, Kioumis I, Pitsiou G, et al. Pneumothorax: from definition to diagnosis and treatment. J Thorac Dis. 2014;6:S372–6.

    Google Scholar 

  16. Loiselle A, Parish J, Wilkens J, et al. Managing iatrogenic pneumothorax and chest tubes. J Hosp Med. 2013;8:402–8.

    Article  PubMed  Google Scholar 

  17. Park J, Young H, Su A, et al. Ultrasound-guided aspiration of the iatrogenic pneumothorax caused by paravertebral block- a case report. Korean J Pain. 2012;25:33–7.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Chen L, Zhang Z. Quantitative imaging in medicine and surgery. Quant Imaging Med Surg. 2015;5:618–23.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David M. Dickerson M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Moore, C.C., Dickerson, D.M. (2018). Pneumothorax After Paravertebral Block and Radiofrequency. In: Anitescu, M., Benzon, H., Wallace, M. (eds) Challenging Cases and Complication Management in Pain Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-60072-7_20

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-60072-7_20

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-60070-3

  • Online ISBN: 978-3-319-60072-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics