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Thoracic paravertebral block for analgesia following liver mass radiofrequency ablation

Departments of ¹ Anaesthesiology and ² Radiology, Texas A&M University System Health Science Centre College of Medicine, Scott & White Hospital, 2401 South 31st Street, Temple, TX 76508, USA

Correspondence: William C Culp, Jr, Assistant Professor, Scott & White Hospital, Department of Anesthesiology, Texas A&M University System Health Science College of Medicine, 2401 South 31st Street, Temple, TX 76508, USA. E-mail: wculpjr{at}mac.com

A 66-year-old man presented for a second attempt of radiofrequency ablation of a metastatic carcinoid liver lesion. The first attempt using intravenous sedation was unsuccessful because of inadequate pain control and subsequent patient combativeness. Despite fentanyl being given during general anaesthesia, the patient complained of severe right flank pain after emergence. A thoracic paravertebral block was performed without complication and the patient's pain decreased to "3 out of 10" on a standard 10-point scale after 10 min, and "0 out of 10" after 30 min. The patient's pain score remained 0 throughout the following day, and no further analgesics were required. Thoracic paravertebral block can provide complete and lasting analgesia following hepatic radiofrequency ablation, and warrants further study for patients undergoing hepatic radiological interventions.