Pulmonary haemorrhage after percutaneous paravertebral block

We describe the management of a 65-yr-old woman anaesthetized for thoracoto my. The patient suffered a pulmonary haemorrhage after percutaneous paraver tebral injection performed using the loss of resistance to saline technique . Thoracotomy at a later date revealed that the lung tissue had become adhe rent to the chest wall and that the paravertebral space was fibrosed second ary to previous surgery. This particular complication of percutaneous parav ertebral block has not been reported previously and raises the question of risk vs benefit of this pre-emptive analgesic technique.