What has gone wrong?
There are many different things that could have gone wrong to require a paravertebral block. Usually, either the chest wall or the nerve that carries painful messages from it has been damaged.
You should discuss the reasons for you needing the paravertebral block with your doctor.
The aim of the procedure is to reduce the pain messages coming from nerves around the chest. It is hoped this will produce long lasting relief from your pain.
Your pain should be reduced and you should be able to move around more easily. It should then be easier to perform your daily activities. The number of painkilling tablets you need to take should also be reduced.
Are there any alternatives?
By the time that you have the paravertebral block you should have already tried other more simple treatments. These include rest, both painkilling and anti-inflammatory tablets, and physiotherapy.
You may also have tried a transcutaneous electrical nerve stimulation (TENS) machine for your pain. This works by sending soothing pulses across the surface of your skin and along the nerve fibres. The pulses prevent pain signals from reaching the brain. They also stimulate your body to produce higher levels of its own natural painkillers, called endorphins.
What if you do nothing?
If you do nothing there are several things that may happen:
Who should have it done?
The following groups of patients should have the procedure done:
Who should not have it done?
Each patient must make the final decision on whether to proceed or not. If you are unhappy about the procedure for any reason you should not continue.
There are specific medical situations when a paravertebral block should not be done and they are as follows:
When a patient is on medication that prevents blood from clotting, such as warfarin. This would lead to more bleeding than normal. It may be possible to stop the medication a few days before the procedure. This will need to be discussed with your doctor
When a patient is suffering from an illness that prevents blood from clotting, such as haemophilia. This would also lead to more bleeding than normal
When there is infection of the skin over the site where the needle needs to be put in. This could lead to infection in the deeper tissues
Also, some patients with severe breathing problems may not be suitable for this procedure.
Author: Dr Sean White FRCA. Consultant in pain and anaesthesia
© Dumas Ltd 2006