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Thoracic Paravertebral Block

Thoracic paravertebral block is the technique by which local anaesthetic is injected in wedge shaped paravertebral space alongside of the vertebral body called the thoracic paravertebral space (TPVS). This provides unilateral somatic and sympathetic blockade at selective segmental regions.

TPVS is a wedge shape space where local anaesthetics block the spinal nerves as they emerge from the intervertebral foramen.

Anterolaterally it is bound by the parietal pleura, medially lies vertebral body with intervertebral disc and the intervertebral foramen with its content forming the base of the wedge. Posterior border is formed by superior costotransverse ligament. Superior costotransverse ligament extends from the lower border of transverse process of vertebra above to the upper border of lower vertebra. Between the parietal pleura and superior costotransverse ligament, a fibroelastic structure called as endothoracic fascia is present dividing the space into two spaces, named anterior space as “extrapleural paravertebral space “ and posterior as “ subendothoracic paravertebral” compartment.

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