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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.
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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