{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T14:34:26Z","timestamp":1792074866884,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2015,8,14]],"date-time":"2015-08-14T00:00:00Z","timestamp":1439510400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"departmental resources"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Infants with long\u2010gap esophageal atresia (<jats:styled-content style=\"fixed-case\">LGEA<\/jats:styled-content>) undergo repeated thoracotomies for staged surgical repair known as the Foker process (<jats:styled-content style=\"fixed-case\">FP<\/jats:styled-content>). Associated prolonged mechanical ventilation results in exposure to high doses of opioids and benzodiazepines, and prolonged weaning times and <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content> stays.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this study was to determine the effectiveness of short\u2010term paravertebral nerve block (<jats:styled-content style=\"fixed-case\">PVNB<\/jats:styled-content>) catheters in reducing opioid\/benzodiazepine exposure and effects on clinical variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The medical records of seventeen infants were retrospectively reviewed; 11 with <jats:styled-content style=\"fixed-case\">PVNB<\/jats:styled-content> and six without (<jats:styled-content style=\"fixed-case\">CG<\/jats:styled-content>). <jats:styled-content style=\"fixed-case\">PVNB<\/jats:styled-content> were placed using ultrasound\u2010guidance and chloroprocaine infusions implemented in the <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content>. Opioids and benzodiazepines were administered via the protocol for 5 days following thoracotomies for Foker\u2010I and Foker\u2010<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Foker\u2010I: Average reduction in morphine and midazolam consumption was 36% (2.18 vs 3.40\u00a0mg\u00b7kg<jats:sup>\u22121<\/jats:sup>\u00b7day<jats:sup>\u22121<\/jats:sup>; <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001) and 31% (2.25 vs 3.25\u00a0mg\u00b7kg<jats:sup>\u22121<\/jats:sup>\u00b7day<jats:sup>\u22121<\/jats:sup>; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.033), respectively, in the <jats:styled-content style=\"fixed-case\">PVNB<\/jats:styled-content> compared with <jats:styled-content style=\"fixed-case\">CG<\/jats:styled-content>. Foker\u2010<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>: Average reduction in morphine and midazolam consumption was 39% (3.19 vs 5.27\u00a0mg\u00b7kg<jats:sup>\u22121<\/jats:sup>\u00b7day<jats:sup>\u22121<\/jats:sup>) and 38% (3.46\u00a0mg\u00b7kg<jats:sup>\u22121<\/jats:sup>\u00b7day<jats:sup>\u22121<\/jats:sup> vs 5.62; <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001), respectively in the <jats:styled-content style=\"fixed-case\">PVNB<\/jats:styled-content> compared with <jats:styled-content style=\"fixed-case\">CG<\/jats:styled-content>. 24\u2010h prior to extubation: Average reduction in morphine and midazolam consumption was 50% (2.91 vs 5.85\u00a0mg\u00b7kg<jats:sup>\u22121<\/jats:sup>\u00b724\u00a0h<jats:sup>\u22121<\/jats:sup>; p\u00a0=\u00a00.023) and 61% (2.27 vs 5.83\u00a0mg\u00b7kg<jats:sup>\u22121<\/jats:sup>\u00b724\u00a0h<jats:sup>\u22121<\/jats:sup>; P\u00a0=\u00a00.004), respectively, in the <jats:styled-content style=\"fixed-case\">PVNB<\/jats:styled-content> compared with <jats:styled-content style=\"fixed-case\">CG<\/jats:styled-content>. Infusion wean time, (independence from opioid\/midazolam infusions) following extubation was 5\u00a0days in the <jats:styled-content style=\"fixed-case\">PVNB<\/jats:styled-content> group and 15\u00a0days in <jats:styled-content style=\"fixed-case\">CG<\/jats:styled-content> (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.005). Median <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content> stay (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>) was 40\u00a0days (34\u201345\u00a0days) in <jats:styled-content style=\"fixed-case\">PVNB<\/jats:styled-content> patients and 71\u00a0days (42\u2013106\u00a0days) in controls (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.02).<\/jats:p><jats:p><jats:styled-content style=\"fixed-case\">PVNB<\/jats:styled-content> catheters were left an average of 7\u00a0days and there were no complications associated with the nerve blocks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Short\u2010term <jats:styled-content style=\"fixed-case\">PVNB<\/jats:styled-content> placement decreases opioid and benzodiazepine exposure, weaning days and <jats:styled-content style=\"fixed-case\">ICU<\/jats:styled-content> stay in infants undergoing prolonged mechanical ventilation for <jats:styled-content style=\"fixed-case\">LGEA<\/jats:styled-content> repair in this small pilot study. Larger studies are warranted to confirm results.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.12736","type":"journal-article","created":{"date-parts":[[2015,8,14]],"date-time":"2015-08-14T09:44:53Z","timestamp":1439545493000},"page":"1151-1157","source":"Crossref","is-referenced-by-count":14,"title":["Paravertebral nerve block catheters using chloroprocaine in infants with prolonged mechanical ventilation for treatment of long\u2010gap esophageal atresia"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9741-6130","authenticated-orcid":false,"given":"Sigrid","family":"Bairdain","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery Boston Children's Hospital Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda","family":"Dodson","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Boston Children's Hospital Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Zurakowski","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Boston Children's Hospital Harvard Medical School Boston MA USA"},{"name":"Department of Anesthesia Boston Children's Hospital Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David B.","family":"Waisel","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Perioperative and Pain Medicine Division of Critical Care Medicine Boston Children's Hospital Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell W.","family":"Jennings","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Boston Children's Hospital Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen R.","family":"Boretsky","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Perioperative and Pain Medicine Division of Critical Care Medicine Boston Children's Hospital Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,8,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clp.2012.04.007"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199710000-00014"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-0489"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(87)90065-1"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.153.4.331"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2011.03638.x"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1992.tb02336.x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12238"},{"key":"e_1_2_10_10_1","first-page":"184","volume-title":"Fundamentals of Biostatistics","author":"Rosner B","year":"2006"},{"key":"e_1_2_10_11_1","first-page":"266","volume-title":"Regression Methods in Biostatistics. Linear, Logistic, Survival, and Repeated Measures Models","author":"Vittinghoff E","year":"2005"},{"key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1080\/01621459.1989.10478802","article-title":"Approximate power for repeated\u2010measures ANOVA lacking sphericity","volume":"84","author":"Muller KE","year":"1989","journal-title":"J Am Stat Assoc"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjaceaccp\/mki014"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001503-200502000-00004"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.1998.00322.x"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.1998.00239.x"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e31826918b6"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3181de6cc5"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/ael020"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0b013e3182176f42"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1994.tb03905.x"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1995.tb06148.x"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-200110000-00018"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2004.01550.x"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/0952-8180(93)90140-A"},{"key":"e_1_2_10_26_1","first-page":"609","article-title":"Thoracic epidural infusion with Chloroprocaine for postoperative analgesia following epicardial pacemaker placement in an infant","volume":"7","author":"Kamata M","year":"2014","journal-title":"J Pain Res"}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fpan.12736","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.12736","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T07:37:41Z","timestamp":1696232261000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pan.12736"}},"subtitle":[],"editor":[{"given":"Adrian","family":"Bosenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2015,8,14]]},"references-count":25,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2015,11]]}},"alternative-id":["10.1111\/pan.12736"],"URL":"https:\/\/doi.org\/10.1111\/pan.12736","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"value":"1155-5645","type":"print"},{"value":"1460-9592","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,8,14]]}}}