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Paravertebral block: anatomy and relevant safety issues
Alberto E Ardon1, Justin Lee2, Carlo D Franco3
1Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL, USA.
Korean Journal of Anesthesiology
|March 17, 2020
Summary
Thoracic paravertebral block offers effective surgical analgesia but carries risks. Careful anatomical knowledge and needle manipulation, like limiting medial/lateral orientation and using caudal redirection, can minimize complications.
Area of Science:
- Anesthesiology
- Regional Anesthesia
- Surgical Procedures
Background:
- Paravertebral block, particularly thoracic paravertebral block, is a valuable regional anesthetic technique.
- It provides significant analgesia for various surgeries, including breast, pulmonary, and herniorrhaphy.
- Despite its effectiveness, the technique has potential adverse effects.
Purpose of the Study:
- To discuss the anatomy and technical aspects of paravertebral blocks.
- To emphasize the importance of proper needle manipulation for minimizing complications.
- To propose safety measures for performing paravertebral blocks.
Main Methods:
- Review of anatomical and technical aspects of paravertebral blocks.
- Discussion of needle manipulation strategies for risk reduction.
- Consideration of landmark-based and ultrasound-guided approaches.
Main Results:
- Proper anatomical knowledge and technique are crucial for decreasing adverse effects.
- Limiting medial and lateral needle orientation and using caudal redirection enhance safety in landmark-based approaches.
- Identifying targets distant from the neurovascular bundle is beneficial in ultrasound-guided procedures.
Conclusions:
- Paravertebral blocks are effective but require meticulous technique to avoid complications.
- Specific needle manipulation strategies can significantly improve the safety margin.
- Enhanced understanding and application of technique are key to successful paravertebral blockade.
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