• Veerandra B Koyyalamudi, Sailesh Arulkumar, Benjamin R Yost, Charles J Fox, Richard D Urman, and Alan David Kaye.
• Department of Anesthesiology, LSUHSC-Shreveport, Shreveport, LA, USA. Electronic address: vkoyya@lsuhsc.edu.
• Best Pract Res Clin Anaesthesiol. 2014 Jun 1;28(2):127-38.

AbstractThere has been a renewed interest in supraclavicular and paravertebral blocks for regional anesthesia. Studies have shown a high block success rate with the supraclavicular approach to the brachial plexus. Despite the use of ultrasound, pleural puncture and pneumothorax may still occur. The supraclavicular block is associated with a higher incidence of phrenic nerve paralysis and caution should be exercised in patients with respiratory difficulties. Paravertebral blocks have been used successfully to provide analgesia and anesthesia for a variety of surgical procedures. When compared to thoracic epidural blockade for thoracic surgery, paravertebral blockade provides comparable analgesia with a better preservation of pulmonary function and a lower incidence of hypotension. This brings forth the question as to whether paravertebral blocks have replaced epidural blockade as the gold standard in perioperative pain management for thoracoabdominal procedures.Copyright © 2014 Elsevier Ltd. All rights reserved.

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