On the basis of the evidence presented in this systematic review, The ASERNIP-S Review Group agreed on the following classifications and recommendations concerning the safety and efficacy of paravertebral block for anaesthesia and analgesia:
Classifications
Evidence rating The evidence-base in this review is rated as average.
Safety Paravertebral blocks at the level of the thoracic and lumbar vertebrae are at least as safe as (1) general anaesthesia and other regional anaesthetic techniques for anaesthesia during surgery, and (2) analgesic drugs and other regional blocks for analgesia postoperatively.
Efficacy Paravertebral blocks at the level of the thoracic and lumbar vertebrae are at least as effective as (1) general anaesthesia and other regional anaesthetic techniques for anaesthesia during surgery, and (2) analgesic drugs and other regional blocks for analgesia postoperatively.
Clinical and Research Recommendations
PVB is an advanced technique, which requires a degree of expertise and competence. It is recommended that anaesthetists wishing to use the PVB technique undergo appropriate training and supervised instruction until competent, and there should be ongoing audit of their performance. Additional high quality, prospective randomised controlled trials would strengthen the evidence base for the PVB technique. Cost-effectiveness studies, taking into consideration the Australian healthcare context should also be considered.