Abstract
Performing a thoracic paravertebral block (TPVB) consists of injecting a local anaesthetic into the thoracic paravertebral space, with the objective of segmental, somatic, and sympathetic ipsilateral anaesthesia. Ultrasound guidance is becoming the gold standard for the majority of practitioners who perform this type of nerve block in routine practice [1].
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05 November 2023
A correction has been published.
References
Chelly JE. Paravertebral blocks. Anesthesiol Clin. 2012;30:75–90.
Karmakar MK. Thoracic paravertebral block. Anesthesiology. 2001;95:771–80.
Karmakar MK, Kwok WH, Kew J. Thoracic paravertebral block: radiological evidence of contralateral spread anterior to the vertebral bodies. Br J Anaesth. 2000;84:263–5.
Karmakar MK, Gin T, Ho AM. Ipsilateral thoraco-lumbar anesthesia and paravertebral spread after low thoracic paravertebral injection. Br J Anaesth. 2001;87:312–6.
Cowie B, McGlade D, Ivanusic J, Barrington MJ. Ultrasound-guided thoracic paravertebral blockade: a cadaveric study. Anesth Analg. 2010;110:1735–9.
Eason MJ, Wyatt R. Paravertebral thoracic block-a reappraisal. Anesthesia. 1979;34:638–42.
Lönnqvist PA, Hildingsson U. The caudal boundary of the thoracic paravertebral space. A study in human cadavers. Anesthesia. 1992;47:1051–2.
Karmakar MK. Ultrasound-guided thoracic paravertebral block. Tech Reg Anesth Pain Manage. 2009;13:142–9.
Komatsu T, Sowa T, Takahashi K, Fujinaga T. Paravertebral block as a promising analgesic modality for managing post-thoracotomy pain. Ann Thorac Cardiovasc Surg. 2013;20(2):113–6.
Thavaneswaran P, Rudkin GE, Cooter RD, Moyes DG, Perera CL, Maddern GJ. Brief reports: paravertebral block for anesthesia: a systematic review. Anesth Analg. 2010;110:1740–4.
Schnabel A, Reichl SU, Kranke P, Pogatzki-Zahn EM, Zahn PK. Efficacy and safety of paravertebral blocks in breast surgery: a meta-analysis of randomized controlled trials. Br J Anaesth. 2010;105:842–52.
Terheggen MA, Wille F, Borel Rinkes IH, Ionescu TI, Knape JT. Paravertebral blockade for minor breast surgery. Anesth Analg. 2002;94:355–9.
Gardiner S, Rudkin G, Cooter R, Field J, Bond M. Paravertebral blockade for day-case breast augmentation: a randomized clinical trial. Anesth Analg. 2012;115:1053–9.
Bugelli GJ, Samra WA, Stuart-Smith K. Simple mastectomy and axillary lymph node biopsy performed under paravertebral block and light sedation in a patient with severe cardiorespiratory comorbidities: proposed management of choice in high-risk breast surgery patients. Clin Breast Cancer. 2013;13:153–5.
Coopey SB, Specht MC, Warren L, Smith BL, Winograd JM, Fleischmann K. Use of preoperative paravertebral block decreases length of stay in patients undergoing mastectomy plus immediate reconstruction. Ann Surg Oncol. 2013;20:1282–6.
Kairaluoma PM, Bachmann MS, Rosenberg PH, Pere PJ. Preincisional paravertebral block reduces the prevalence of chronic pain after breast surgery. Anesth Analg. 2006;103:703–8.
Daly DJ, Myles PS. Update on the role of paravertebral blocks for thoracic surgery: are they worth it? Curr Opin Anaesthesiol. 2009;22:38–43.
Fortier S, Hanna HA, Bernard A, Girard C. Comparison between systemic analgesia, continuous wound catheter analgesia and continuous thoracic paravertebral block: a randomised, controlled trial of postthoracotomy pain management. Eur J Anaesthesiol. 2012;29:524–30.
Davies RG, Myles PS, Graham JM. A comparison of the analgesic efficacy and side-effects of paravertebral vs epidural blockade for thoracotomy: a systematic review and meta-analysis of randomized trials. Br J Anaesth. 2006;96:418–26.
Powell ES, Cook D, Pearce AC, et al.. UKPOS InvestigatorsA prospective, multicentre, observational cohort study of analgesia and outcome after pneumonectomy. Br J Anaesth. 2011;106:364–70.
Murata H, Salviz EA, Chen S, Vandepitte C, Hadzic A. Case report: ultrasound-guided continuous thoracic paravertebral block for outpatient acute pain management of multilevel unilateral rib fractures. Anesth Analg. 2013;116:255–7.
Langille GM, Launcelott GO, Rendon RA. Access to the extrapleural space at the time of surgery for continuous paravertebral block after flank incision: description of the technique and case series. Urology. 2013;81:675–8.
Ozkan D, Akkya T, Comert A, et al. Paravertebral block in inguinal hernia surgeries: 2 segments or 4 segments? Reg Anesth Pain Med. 2009;34:312–5.
Hadzic A, Kerimoglu B, Loreio D, et al. Paravertebral blocks provide superior same-day recovery over general anesthesia for patients undergoing inguinal hernia repair. Anesth Analg. 2006;102:1076–81.
Akcaboy EY, Akcaboy ZN, Gogus N. Ambulatory inguinal herniorraphy: paravertebral block versus spinal. Minerva Anesthesiol. 2009;75:684–91.
Naja ZM, Raf M, El-Rajab M, et al. A comparison of nerve stimulator guided paravertebral block and Ilio-inguinal nerve block for analgesia after inguinal herniorrhaphy in children. Anesthesia. 2006;61:1064–8.
Kaur B, Vaghadia H, Tang R, Sawka. A real-time thoracic paravertebral block using an ultrasound-guided positioning system. Br J Anaesth. 2013;110:852–3.
Kus A, Gurkan Y, Gul Akgul A, Solak M, Toker K. Pleural puncture and intrathoracic catheter placement during ultrasound guided paravertebral block. J Cardiothorac Vasc Anesth. 2013;27:e11–2.
Conacher ID, Kokri M. Post-operative paravertebral blocks for thoracic surgery. A radiological appraisal. Br J Anaesth. 1987;59:155–61.
Conacher ID. Resin injection of thoracic paravertebral spaces. Br J Anaesth. 1988;61:657–61.
Purcell-Jones G, Pither CE, Justins DM. Paravertebral somatic nerve block: a clinical, radiographic, and computed tomographic study in chronic pain patients. Anesth Analg. 1989;68:32–9.
Richardson J, Jones J, Atkinson R. The effect of thoracic paravertebral blockade on intercostal somatosensory evoked potentials. Anesth Analg. 1998;87:373–6.
Cheema SP, Ilsley D, Richardson J, Sabanathan S. A thermographic study of paravertebral analgesia. Anesthesia. 1995;50:118–21.
Marhofer D, Marhofer P, Kettner SC, et al. Magnetic resonance imaging analysis of the spread of local anesthetic solution after ultrasound-guided lateral thoracic paravertebral blockade: a volunteer study. Anesthesiology. 2013;118:1106–12.
Ponde VC, Desai AP. Echo-guided estimation of formula for paravertebral block in neonates, infants and children till 5 years. Indian J Anaesth. 2012;56:382–6.
Renes SH, Bruhn J, Gielen MJ, Scheffer GJ, van Geffen GJ. In-plane ultrasound-guided thoracic paravertebral block: a preliminary report of 36 cases with radiologic confirmation of catheter position. Reg Anesth Pain Med. 2010;35:212–6.
Marhofer P, Kettner SC, Hajbok L, Dubsky P, Fleischmann E. Lateral ultrasound-guided paravertebral blockade: an anatomical-based description of a new technique. Br J Anaesth. 2010;105:526–32.
Luyet C, Meyer C, Herrmann G, Hatch GM, Ross S, Eichenberger U. Placement of coiled catheters into the paravertebral space. Anesthesia. 2012;67:250–5.
O'Riain SC, Donnell BO, Cuffe T, Harmon DC, Fraher JP, Shorten G. Thoracic paravertebral block using real-time ultrasound guidance. Anesth Analg. 2010;110:248–51.
Bouzinac A, Delbos A, Mazières M, Rontes O. Ultrasound-guided bilateral paravertebral thoracic block in an obese patient. Ann Fr Anesth Réanim. 2011;30:162–3.
Shibata Y, Nishiwaki K. Ultrasound-guided intercostal approach to thoracic paravertebral block. Anesth Analg. 2009;109:996–7.
Ben-Ari A, Moreno M, Chelly JE, Bigeleisen PE. Ultrasound-guided paravertebral block using an intercostal approach. Anesth Analg. 2009;109:1691–4.
Luyet C, Eichenberger U, Greif R, Vogt A, Szücs Farkas Z, Moriggl B. Ultrasound-guided paravertebral puncture and placement of catheters in human cadavers: an imaging study. Br J Anaesth. 2009;102:534–9.
Hara K, Sakura S, Nomura T, Saito Y. Ultrasound guided thoracic paravertebral block in breast surgery. Anesthesia. 2009;64:223–5.
Luyet C, Herrmann G, Ross S, et al. Ultrasound-guided thoracic paravertebral puncture and placement of catheters in human cadavers: where do catheters go? Br J Anaesth. 2011;106:246–54.
Pusch F, Wildling E, Klimscha W, Weinstabl C. Sonographic measurement of needle insertion depth in paravertebral blocks in women. Br J Anaesth. 2000;85:841–3.
Kaur B, Tang R, Vaghadia H, Sawka A. Ultrasound-guided thoracic paravertebral block using the SonixGPS® system in human cadavers. Can J Anaesth. 2013;60:331–2.
Karmakar MK, Li X, Li J, Hadzic A. Volumetric three-dimensional ultrasound imaging of the anatomy relevant for thoracic paravertebral block. Anesth Analg. 2012;115:1246–50.
Bouaziz H, Aubrun F, Belbachir AA, et al. Société française d'anesthésie et de réanimation. Locoregional anesthesia and echography. Ann Fr Anesth Réanim. 2011;30:e33–5.
Luyet C, Siegenthaler A, Szucs-Farkas Z, Hummel G, Eichenberger U, Vogt A. The location of paravertebral catheters placed using the landmark technique. Anesthesia. 2012;67:1321–6.
Lichtenstein DA, Menu Y. A bedsign ultrasound signruling out pneumothorax in the critically ill. Lung sliding. Chest. 1995;108:1345–8.
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Eisenberg, E., Gaertner, E., Clavert, P. (2023). Thoracic Paravertebral Block. In: Eisenberg, E., Gaertner, E. (eds) Ultrasound in Peripheral, Neuraxial and Perineuraxial Regional Anaesthesia. Springer, Cham. https://doi.org/10.1007/978-3-031-08804-9_10
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DOI: https://doi.org/10.1007/978-3-031-08804-9_10
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