A Clinical Overview Of Paravertebral Blockade

Abstract

Paravertebral somatic nerve blockade (PVB) is an old technique that was first described in 1919 by Kappis. It was initially utilized as an alternative to spinal anesthesia which would minimize the cardiovascular and respiratory effects of central neuraxial block. However, after its initial description PVB’s were used sparingly to provide anesthesia and analgesia. More recently, there has been renewed interest in this technique for the treatment of acute and chronic pain. Paravertebral nerve blocks involve injection of local anesthetic in a space immediately lateral to where the spinal nerves emerge from the intervertebral foramina. Because of the ability to provide long-lasting unilateral anesthesia, PVBs have been successfully used to provide analgesia for multiple thoracic and abdominal procedures in both children and adults. At our institution, this technique has been extensively employed to provide anesthesia for a variety of breast cancer procedures, inguinal herniorrapphy, thoracotomy and non-invasive heart surgery.