Ultrasound-Assisted Paravertebral Block v. Traditional Paravertebral Block For Pain Control

Exclusion Criteria

• •1\) Age younger than 18 years or older than 75 years
• •(2) Any contraindication to the placement of unilateral thoracic paravertebral catheter, including local infection, hypocoagulable state.
• •(3) American Society of Anesthesiologists physical status IV or greater
• •(4) chronic painful conditions
• •(5) preoperative opioid use
• •(6) coagulation abnormalities or patients who are expected to be on therapeutic anticoagulants postoperatively
• •(7) allergy to lidocaine, ropivacaine or bupivacaine
• •(8) personal or family history of malignant hyperthermia
• •(9) serum creatinine greater than 1.4 g/dl
• •(10) pregnancy or lactating.The pregnancy status will be determined by history and prior pregnancy testing when appropriate
• •(11) having an altered mental status (not oriented to place, person, or time) or emergency surgery
• •(12) comorbid conditions such as sepsis, unstable angina, congestive heart failure, moderate to severe valvular heart disease, severe chronic obstructive pulmonary disease (COPD)
• •(13) patient's inability to provide adequate informed consent
• •(14) patient refusal to nerve blocks and/or participation in the study
• •(15) respiratory support via ventilator post
• •(16) non English speaking
• •(17) allergy to contrast of iodine
• •(18) emergency surgery or any other non-elective procedure
• •(19) unstable vertebral and transverse process fractures