Ipsilateral thoraco-lumbar anaesthesia and paravertebral spread after low thoracic paravertebral injection

Coexisting harlequin and Horner syndromes after high thoracic paravertebral anaesthesia.

A patient undergoing left mastectomy and immediate latissimus dorsi breast reconstruction under combined paravertebral block and general anaesthesia developed transient, well-demarcated, right-sided hemifacial erythema and sweating, and left-sided Horner syndrome postoperatively. This "harlequin" appearance occurs because of a normal or excessive vasodilatory, thermoregulatory response to heat ...

Thoracic paravertebral block.

THORACIC paravertebral block (TPVB) is the technique of injecting local anesthetic adjacent to the thoracic vertebra close to where the spinal nerves emerge from the intervertebral foramina. This results in ipsilateral somatic and sympathetic nerve blockade in multiple contiguous thoracic dermatomes above and below the site of injection. It is effective in treating acute and chronic pain of uni...

Total Spinal Block after Thoracic Paravertebral Block.

Thoracic paravertebral block (TPVB) can be performed with or without general anaesthesia for various surgical procedures. TPVB is a popular anaesthetic technique due to its low side effect profile and high analgesic potency. We used 20 mL of 0.5% levobupivacaine for a single injection of unilateral TPVB at the T7 level with neurostimulator in a 63 year old patient with co-morbid disease who und...

Thoracic paravertebral blockade.

Thoracic paravertebral blockade is a simple and easy-to-learn technique with a low incidence of complications. It should be considered as a safe alternative to thoracic epidural analgesia/anaesthesia. We reviewed the techniques of thoracic paravertebral blockade with special interest to ultrasound guidance.

Thoracic paravertebral nerve block.