Thoracic paravertebral block (PVB) analgesia

Abstract

Paravertebral blockade is a safe and effective technique for intraoperative and postoperative management of acute surgical pain. The block may be performed as a single injection or a catheter may be inserted to allow for the continuous or bolus administration of a long acting local anaesthetic. This mode of analgesia is not considered to be a stand alone technique (in contrast to epidural analgesia) and most patients will require additional analgesia (usually parenteral patient controlled analgesia). Compared to epidural analgesia, the paravertebral administration of analgesia is considered to be safer in anti-coagulated patients, but the risk of local anaesthetic toxicity remains. There is little published about the care of patients receiving this form of analgesia. This article provides an overview of the technique of thoracic paravertebral analgesia, the choice of analgesics and side effects together with recommendations for patient care.