Block It Like Itâs Hot: Regional Anesthesia, Pain Medicine & POCUS S3:E1 "Paravertebral: The King of Nerve Blocks đ (Part I)"
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Jan 15, 2025 Amit and Jeff dive into the fascinating world of paravertebral blocks, sharing their personal journeys and memorable first experiences with this technique. They explore its historical decline and resurgence, fueled by the rise of ultrasound technology. With a touch of humor, they discuss common clinical indications, probe selection, and patient positioning challenges. Listeners will appreciate practical tips on monitoring and needle techniques, all while enjoying the hosts' lighthearted banter and engaging anecdotes.
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Early Landmark PVB Stories
- Jeff recalled a landmark-era PVB where a needle caused a small pneumothorax but the patient did fine.
- Amit described his first landmark PVB where the anesthetic bleb was visible during surgery.
Landmark Technique Is Unreliable
- A simulator study showed over half of landmark PVB attempts missed the paravertebral space or entered the pleura.
- This evidence motivated a move toward ultrasound-guided techniques.
Prefer PVB For Thoracic And Breast
- Use PVBs primarily for thoracic surgery and breast operations; they provide excellent unilateral chest analgesia.
- Consider PVBs for selected unilateral abdominal and inguinal procedures when appropriate.