Article Text

Download PDFPDF
Extended Unilateral Anesthesia: New Technique or Paravertebral Anesthesia?
  1. Toshiyuki Saito, M.D.*,
  2. Edward T. Gallagher, B.S.*,
  3. Stephen Cutler, B.S.*,
  4. Kumiko Tanuma, D.V.M.*,
  5. Koki Yamada, M.D.*,
  6. Noriyuki Saito, M.D.,
  7. Koichi Maruyama, M.D.* and
  8. Christer Carlsson, M.D., Ph.D.
  1. *Department of Anesthesiology, Nippon Medical School, Tama-Nagayama Hospital, Tokyo, Japan, the
  2. Department of Laboratory Medicine and Clinical Laboratory Center, Gunma University School of Medicine, Gunma, Japan, and the
  3. Department of Anesthesiology, Temple University Medical School, Philadelphia, Pennsylvania
  1. Reprint requests: Toshiyuki Saito, M.D., 1236-7 Kagawa, Chigasaki City, Kanagawa Prefecture 253, Japan.


Background and Objectives The authors previously reported a case in which injection of local anesthetic posterior to the endothoracic fascia at the T11 vertebral level gave rise to extended analgesia in thoracic and lumbar dermatomes. They now report a study in which this type of anesthesia was used in patients undergoing herniorrhaphy.

Methods A 12-mL dose of 2% mepivacaine was injected at the T11 level posterior to the endothoracic fascia in 15 patients.

Results On average, seven dermatomes could be blocked with this dose and with a single injection. Nine patients experienced adequate analgesia and underwent operation with no additional sedation. In three patients the block resulted in inadequate analgesia, and additional sedative drugs were used. Three patients experienced no analgesia and were given general anesthesia.

Conclusion Injection of local anesthetic posterior to the endothoracic fascia resulted in extended unilateral anesthesia that was adequate for herniorrhaphy in 9 of the 15 patients (60%) studied.

  • herniorraphy
  • endothoracic fascia (parietal thoracic fascia)
  • extended unilateral analgesia
  • mepivacaine

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • This study was performed at Nippon Medical School, Tama-Nagayama Hospital, Tokyo, Japan.