Abstract

The paravertebral nerve block (PVB) allows the blockade of mixed nerve roots after they leave the intervertebral foramina. This provides anesthesia and analgesia for a variety of procedures and conditions including: breast surgery, thoracic surgery (thoracotomies, thoracoscopies, VATS), multiple rib fractures, herniorrhaphies, abdominal wall procedures; and to provide analgesia and anesthesia in the presence of severe scoliosis, kyphosis or Harrington rods; and also to treat chronic pain syndromes. The principal contraindications remaon infection, major coagulopathy, neuropathy of unknown origin and patient refusal. The use of catheters permits a longer duration of therapy. Complications include possible pneumothorax, intraneural injection, epidural spread and local anesthetic toxicity. This is a very useful technique to master.