Somatic paravertebral nerve blockade

The failure rate and complications following thoracic and lumbar paraverteb ral blocks performed in 620 adults and 42 children were recorded. The techn ique failure rate in adults was 6.1%. No failure, occurred in children. The complications recorded were: inadvertent vascular puncture (6.8%); hypoten sion (4.0%); haematoma (2.4%); pain at site of skin puncture (1.3%); signs of epidural or intrathecal spread (1.0%); pleural puncture (0.8%): pneumoth orax (0.5%). No complications were noted in the children. The use of a bila teral paravertebral technique was found approximately to double the likelih ood of inadvertent vascular puncture (9% vs. 5%) and to cause an eight-fold increase in pleural puncture and pneumothorax (3% vs. 0.4%), when compared with unilateral blocks. The incidence of other complications was similar b etween bilateral and unilateral blocks.