We present a technique of retrosternal block for symptomatic treatment for dyspnoea of various aetiologies. In our experience with 20 patients, a retrosternal block using lignocaine improved symptoms within minutes. The block was easy to perform and was helpful when the patients’ symptoms were not relieved by conventional therapy. Prospective controlled studies are needed to further assess this simple and promising treatment.
IngramR.H.Jr., BraunwaldE.Dyspnea and pulmonary edema. In: BraunwaldE., FauciA.S., KasperD.L., HauserS.L., LongoD.L., JamesonJ.L. eds. Harrison's Principles of Internal Medicine.15th Edition.McGraw-Hill Medical Publishing Division, New York, 2001; 199–203.
2.
YernaultJ.C.Dyspnoea in the elderly: a clinical approach to diagnosis.Drugs Aging2001; 18: 177–187.
3.
ManningH.L., SchwartzsteinR.M.Pathophysiology of dyspnea.N Engl J Med1995; 333: 1547–1553.
4.
KonH., AokiM., YamamotoS.A case of successfully managed acute asthmatic attack by cervical epidural block during mechanical ventilation.Kokyu To Junkan1990; 38: 1041–1044. [Japanese.]
5.
GroebenH., SchwalenA., IrsfeldS.High thoracic epidural anesthesia does not alter airway resistance and attenuates the response to an inhalational provocation test in patients with bronchial hyperreactivity.Anesthesiology1994; 81: 868–874.
6.
FornelíM.B.Clinico-experimental basis of prolonged-action retrosternal block in coronary insufficiency.Kardiologiia1966; 6: 69–72. [Russian.]
7.
NeimarkI.I., FornelíM.B.Treatment of coronary insufficiency by applying retrosternal potentiated block.Sov Med1966; 29: 61–65.[Russian.]
8.
BarabashF.M.Treatment of acute coronary insufficiency with retrosternal novocaine blocks.Vrach Delo1967; 6: 128–130. [Russian.]
9.
DrevinaA.I., MotusO.I., NikandrovaK.A.Remote results of angina pectoris therapy using retrosternal novocaine block.Ter Arkh1978; 50: 37–39. [Russian.]
10.
SmirnovD.A., PlashchevskiiA.T.Retrosternal novocaine blockade in the treatment of severe forms of bronchial asthma and status asthmaticus.Anesteziol Reanimatol1991; 2: 49–50. [Russian.]
11.
ManningH.L., BasnerR., RinglerR.Effect of chest wall vibration on breathlessness in normal subjects.J Appl Physiol1991; 71: 175–181.
12.
SibuyaM., YamadaM., KanamaruA.Effect of chest wall vibration on dyspnea in patients with chronic respiratory disease.Am J Respir Crit Care Med1994; 149: 1235–1240.
13.
BarnesP.J.Neural control of human airways in health and disease.Am Rev Respir Dis1986; 134: 1289–1314.
14.
BarnesP.J.Modulation of neurotransmission in airways.Physiol Rev1992; 72: 699–729.
15.
GroebenH.Effects of high thoracic epidural anesthesia and local anesthetics on bronchial hyperreactivity.J Clin Monit Comput2000; 16: 457–463.
16.
GoodmanN.W., StratfordN.Effect of i.v. lignocaine on the breathing of patients anaesthetized with propofol.Br J Anaesth1995; 75: 573–577.
17.
RuthR.A., GalT.J., DiFazioC.A., MoscickiJ.C.Brain-stem auditory-evoked potentials during lidocaine infusion in humans.Arch Otolaryngol1985; 111: 799–802.