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Paravertebral Space Anatomy — FRCA Final MCQ

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HardRegional AnaesthesiaParavertebral Space AnatomyFRCA Final

A 55-year-old woman (ASA II) undergoes a right mastectomy under general anaesthesia with a paravertebral block. The paravertebral block is placed at T3 level with 20 mL of 0.375% ropivacaine. Which space does the local anaesthetic occupy?

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Correct answer: A — The wedge-shaped paravertebral space bounded by the vertebral body, pedicle, and pleura

The thoracic paravertebral space is a wedge-shaped area bounded: medially by the vertebral body and intervertebral disc, anterolaterally by the parietal pleura, posteriorly by the superior costotransverse ligament and the transverse process. Local anaesthetic injected here spreads craniocaudally to block multiple ipsilateral spinal nerve roots (dorsal and ventral rami) and sympathetic chain. It provides excellent unilateral somatic and sympathetic blockade with fewer haemodynamic effects than epidural.

Reference: RCOA – 2023 – Regional anaesthesia module; Karmakar MK – 2001 – Thoracic paravertebral block