The thoracic paravertebral space begins at T1 and extends caudally to terminate at T12. Although paravertebral blocks can be performed in the vertical and lumbar regions, there is no direct communication between adjacent levels in these areas. Most PVBs are therefore performed at thoracic level 3.The concept of PVB was pioneered by Hugo Sellheim of Leipzig in 1905. It was further refined by Lawen (1911) and Kappis (1919).
The technique however remained neglected till the late 1970s, when a renewed interest developed in the topic due to efforts from Eason and Wyatt who presented a reappraisal on Thoracic ParaVertebral Block (TPVB). They found it to be an accurate, simple and safe method which carried significant advantages over intercostal or epidural block. It was initially utilized as an alternative to spinal anaesthesia which would minimize the cardiovascular and respiratory effects of central neuraxial block. More recently, there has been renewed interest in this technique for the treatment of acute and chronic pain. Because of the ability to provide long-lasting unilateral anaesthesia, PVB have been successfully used to provide analgesia for multiple thoracic and abdominal procedures in both children and adults10.
There are conflicting contrast studies in cadavers with regards to communication between the thoracic and lumbar PVS.Even the TPVB has been shown to have an unpredictable spread 4. The research project focuses on evaluating and possibly overcoming the gaps in the existing knowledge of TPVS in conclusive evidence. The objectives also include finding the depth at which the needle would be entered and also aims to evaluate the success and failure rates as experienced while performing the research. A detailedknowledge of the anatomy of the TPVS, content and adnexa is essential in understanding the clinical consequences of TPVB.The project would be helpful in finding out the adnexa of the region and the spread of anaesthetics which stands controversial on the basis of our current knowledge.