Hadzic's Peripheral Nerve Blocks and Anatomy for Ultrasound-Guided Regional Anesthesia, 2e > Section 6. Ultrasound-Guided Neuraxial and Perineuraxial Blocks > Chapter 45. Sonography of Thoracic Paravertebral Space and Considerations for Ultrasound-Guided Thoracic Paravertebral Block Catherine Vandepitte, Tatjana Stopar Pintaric, Philippe E. Gautier

Sonography of Thoracic Paravertebral Space and Considerations for Ultrasound-Guided Thoracic Paravertebral Block: Introduction

"Thoracic paravertebral block (PVB) is a well-established technique for perioperative analgesia in patients having thoracic, chest wall, or breast surgery or for pain management with rib fractures. Ultrasound guidance can be used to help identify the paravertebral space (PVS) and needle placement, and to monitor the spread of the local anesthetic. Importantly, interference of the closely related osseous structures with ultrasound imaging and the proximity of the highly vulnerable neuraxial structures make it imperative that all well-described technique precautions are exercised, regardless of the ultrasound imaging. In this chapter, we describe general principles of thoracic PVB, rather than propose a cookbook with specific techniques and step-by-step directions. The reader is advised to use the anatomic information and techniques presented here to devise an approach in line with own clinical experience...."