How I Perform US-Guided Paravertebral Blocks

In this short lecture - I describe how I perform Ultrasound-guided Paravertebral blocks with some of the tips and tricks. I also cover the anatomy and sonoanatomy of the paravertebral space.
This lecture was originally delivered at the Romandie Day of Regional Anaesthesia 2019 in Lausanne, Switzerland, for Dr Eric Albrecht's course, but has been adapted for Dr Sara Amaral (aka Blocker Girl) and her on-line course in 2022

[@19sat1]

absolutely stunning presentation.Loved it entirely.

[@DrAmitPawa]

Thank you so much for your kind words 🙏🏽

[@SamtaniPradeep]

Excellent video presentation Sir
Showing insights on how you perform this block, need more such videos Sir

[@DrAmitPawa]

Thank You So Much. That is very kind. More are definitely on the way! 🙏🏽

[@khaledhbenhusainbenhusain404]

excellent video presentation, comprehensive material .... thanks a lot sir

[@DrAmitPawa]

Thank you so much for watching!

[@katienewell9605]

I have been having these blocks done for a number of years now with my amazing pain consultant here in Liverpool… I have them done every 4-6 weeks depending on my pain scale.
It works wonders for my kidney pain, it doesn’t take the pain completely away, however it makes it a lot more bearable.
In all the years I’ve been having this procedure, I’ve never encountered any issues at all, and it must be at least 10 years I’ve been having it done… the only part I can’t stand but I just tolerate it, is that “popping” part when the needle enters the space, that’s when my doctor knows he’s in the correct part.
Thank you for the informative video, I’ve been wanting to watch one on this procedure for a while so thank you very much Dr Amit ❤

[@DrAmitPawa]

Thank you for sharing your experiences and for taking the time to watch the video and feedback. I really appreciate it

[@katienewell9605]

@@DrAmitPawa you’re very welcome!
I’ve managed to come of some pretty hardcore painkillers now I’ve been having this done regularly which can only be a good thing! I still have to take painkillers, but I’ve gone from fentanyl lozenges to codiene… big difference! Xx

[@khalidsofi]

Thank you Dr Amit

[@DrAmitPawa]

Thank you!

[@naochateia]

Thanks for the great video Dr Amit Pawa! Outstanding.

[@DrAmitPawa]

Thanks so much🙏🏽🙏🏽

[@McMedicful]

Great video! Thank you for sharing your experience!

[@DrAmitPawa]

Thank you for watching!

[@timjen764]

That’s a very good video Dr Pawa! Thank you!

[@DrAmitPawa]

Thanks so much. That is very kind

[@Peddoc]

Clear as crystal as they say...Wonderfully explained....I will be using this video to explain PVB for my trainees as well..Thank you Dr. Pawa

[@DrAmitPawa]

Wow! Thanks so much. What a wonderful compliment 🙏🏽🙏🏽

[@RAP.Pocus2024]

Excellent! Thank you!

[@DrAmitPawa]

Thank you for watching!

[@haddymcbatty]

Great video. Thanks.

[@DrAmitPawa]

Thank You So Much!

[@drcliff1983]

Really great video, thank you!

[@DrAmitPawa]

Thanks so much! 🙏🏽

[@syedzulfiqarali4278]

Well done, Amit
Very clear RUclips on USG GUIDED PARAVERTEBRAL BLOCK❤

[@DrAmitPawa]

Thank You so much 🙏🏽

[@tktnidjet]

Thanks for the great video!

[@DrAmitPawa]

Glad you liked it! Many thanks

[@user-sb8zr7xk3t]

Amazing video....Thanks prof.

[@DrAmitPawa]

Thanks so much. I am not a prof (yet!), but happy you found it useful!

[@bhanukavidanapathirana4735]

Amazing presentation Dr Pawa ❤❤❤

[@DrAmitPawa]

Thanks so much! Really appreciate it🙏🏽

[@user-sb8zr7xk3t]

I am very interested in this block.
Outstanding explanation, sir.
In Arabic, روعة 👌

[@DrAmitPawa]

Thanks so much!

[@user-sb8zr7xk3t]

Thanks

[@avijitmou]

Excellent

[@DrAmitPawa]

Thank you so much 🙏🏽

[@MoHadeg]

Thank you

[@DrAmitPawa]

Thank you!

[@nicolascrescimone]

Very nice video

[@DrAmitPawa]

Thanks so much!!

[@tauheedshaikh7169]

I have seen your article also on awake breast surgery, I am curious from a nerve supply perspective would not a PECS1 block be more appropriate than a PEC 2 block ? the high spread form PVB would cover the thoracic dermatomes including ICBN but surely its the medial and lateral pectoral nerve that would be missed as it comes from higher up? thanks in advance for any explanation.

[@DrAmitPawa]

Thanks for watching and reading. Just to clarify- part of the issue with nomenclature and why it has recently changed, is that a PECS 2 block had BOTH injection endpoints, the Interpectoral, And Pectoserratus-
So when talking about performing a PECS 2 block, I am referring to both blocks you describe.
I am not quite sure I understand your question, but to clarify- medial and lateral pectoral nerves have No Cutaneous supply, so when I add them, it is to cover axillary node dissection surgery, or to facilitate awake breast surgery really.
Hope that helps

[@user-sb8zr7xk3t]

Wow

[@plimbu97]

Could u please share us how u accurately identify paravertebral level?

[@DrAmitPawa]

Certainly - I scan over the ribs with paramedian sagittal probe orientation, starting high up over rib 1 - and count down. I will make my own video, but this is expertly demonstrated in Ki Jinn Chin’s video here: ruclips.net/video/c7lQfrYZsp0/видео.html

[@neerajnarang5872]

Great

[@DrAmitPawa]

🙏🏽 Thank You!

[@ahmedelgamassy4567]

Great work.
Would you please tell me your preference or experience with catheter placement for postoperative analgesia.
Thanks and Regards

[@DrAmitPawa]

Thank you. In my practice i very rarely site Catheters, but if i do, either transverse or paramedian approaches will suffice. The key is not to place more than 3 cm in the space

[@psychiatrist123]

How does this reduce cancer recurrence ?

[@DrAmitPawa]

Paravertebral blocks have not been shown to reduce cancer recurrence, but there was a lot of excitement after one retrospective study, and a couple of small prospective studies suggested that maintaining Immune competency around the time of surgery may have an impact. The only randomised prospective large multi-centre trial that has subsequently taken place has not supported this claim.

[@user-sb8zr7xk3t]

What is the average analgesic duration after single shot for cancer breast???

[@DrAmitPawa]

Approximately 24hrs!