Thoracic paravertebral block: a method of pain control

The adverse effects of pain on acutely ill or traumatized patients are well documented. A variety of pain–relieving techniques are now available to meet the varied requirements for pain relief. This paper presents the results of a single, large–volume injection of bupivacaine 0.5% in the thoracic paravertebral space, achieving pain relief over several thoracic dermatomes in patients with respiratory compromise secondary to thoracic or upper abdominal injury. The block proved quick and simple to perform, with excellent clinical results of long duration and virtually no complications. Although not previously described, this single, large–volume injection approach to achieving an extensive thoracic paravertebral block may well become an important pain management technique in appropriate patients.