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Paravertebral block


Key Points

  • The thoracic paravertebral block, with or without catheter, can be used in lieu of thoracic epidural catheter for unilateral procedures and for breast surgeries.

  • Pneumothorax is the major complication of this block.

  • When performing the block and the injection, make sure the needle tip always remains visible in the plane.

Indications

  • Thoracic paravertebral catheter can be used in lieu of thoracic epidural analgesia for unilateral procedures like thoracotomies, nephrectomies (either partial or radical), rib fractures, and breast surgeries.

  • This block is used in cases where epidural catheter is difficult or epidural analgesia failed, for unilateral procedures.

  • Bilateral paravertebral blocks, with or without catheter insertion, can be used for bilateral procedures taking care to avoid the development of bilateral pneumothoraces and local anesthetic overdose toxicity.

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