Pp. 47-56 (10)
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.
Breast surgery, Herniorrhaphies, Paravertebral catheter, Paravertebral
nerve block (PVB), Rib fractures, Thoracoscopies, Thoracotomy, VATS.
Mayo Clinic, Jacksonville, Florida, USA.