Sir,—We were particularly interested in the findings of Drs Conacher and Kokin's radiological study of paravertebral block [1], but feel that this is potentially misleading. Our observations from a continuing series of 45 cases of paravertebral block contrast significantly with the findings in their small study. Using a modification of Moore's technique we have injected 0.75 % bupivacaine 5 ml,...

Sir,—I agree entirely with this view that paravertebral block would provide reduction in requirement for morphine, greater than that achieved with the intercostal block used in our technique. Several of the chest radiographs, including the one in the article, demonstrated contrast medium in the paravertebral space. The statement "it should not be assumed that an intercostal injection of contras...

An appropriate post operative analgesia after thoracotomies is mandatory to improve the patient's outcome, reduce complications rate, morbidity, hospital cost and length of stay. In this paper we review the evidences regarding the use of paravertebral block for thoracic surgery. In particular we examine the effect of paravertebral block compared to the other technique in four major issues: anal...

Computed tomography (CT) were performed in 17 adults with osteomyelitis of the spine. The dominant features were paravertebral soft-tissue swelling, abscess formation, and bone erosion. In two patients there were no findings indicative of osteomyelitis on conventional radiographs, but CT revealed paravertebral abscesses and bone lysis, helping to establish the diagnosis of osteomyelitis. CT was...

To the Editor:—I wish to congratulate Dr. Karmakar on his very thorough and informative review on paravertebral anesthesia and analgesia. 1Dr. Karmakar has overlooked one technique of paravertebral blockade that, in my opinion, has shown particular merit and is worthy of further investigation—the use of a nerve stimulator. To my knowledge, the use of a nerve stimulator as a guide to the perform...

Thorasic paravertebral block (PVB) thorasic epidural and pectoral nerve blocks can be used as a regional anesthetic option for breast surgery. Thorasic PVB is defined as injection of local anesthesthetic solution at the site where spinal nerves emerges from paravertebral foramen. It produces unilateral motor, sensory and sympathetic block, hence PVB could be an anesthetic choice in patients wit...

An association between intercostal nerve block and the development of a total spinal is rare. Usually, subarachnoid injection is considered to have followed intraneural placement or inadvertent entrance into a dural cuff extending beyond an intervertebral foramen. We report a patient that followed injection of local anaesthetic into a paravertebral catheter sited at surgery in the thoracic para...