Paravertebral block – A new standard for perioperative analgesia

SummaryHugo Sellheim of Leipzig introduced the paravertebral block in 1905. The improvement in general anaesthesia led to Eason and Wyatt reviving this almost forgotten technique in 1979. This review first highlights important anatomical features with respect to their implications for single shot and continuous regional anaesthesia, secondly focuses on the current clinical concepts of paravertebral block, and third discusses evidence of efficacy and safety. MEDLINE, EMBASE and the Cochrane Library were searched up to May 2013. Various technical refinements for successful needle placement, enhanced efficacy and safety of paravertebral block make it suitable as a new standard for perioperative analgesia. Further clinical trials, however, are necessary to particularly address issues of safety or the impact of pigtail catheters.