Techniques de réalisation du bloc paravertébral thoracique échoguidé

Ultrasound-guided paravertebral block is performed with a placement of the probe (12 MHz) in the paramedian sagittal plan or in the transverse plan. The main landmark is the hyperechogenic image of the parietal pleura, moving with respiratory movements. The needle is introduced most of the time in plane and sometimes out of plane when the probe is sagittal. The injection of the local anaesthetic solution when the needle tip is close to the pleura at the angle of the transverse facet shadow pushes downward the parietal pleura. Paravertebral block is mainly used for postoperative analgesia after thoracic and breast surgery.