Paravertebral Block Pneumothorax Rate — FRCA Final MCQ

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ModerateRegional AnaesthesiaParavertebral Block Pneumothorax RateFRCA Final

A 48-year-old woman (ASA II) requires a mastectomy and sentinel lymph node biopsy. She asks about the paravertebral block you have recommended for postoperative analgesia. What is the approximate incidence of pneumothorax with ultrasound-guided paravertebral block?

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Correct answer: C — 0.5-1%

The incidence of pneumothorax with paravertebral block varies by technique. With the traditional landmark technique, reported rates were approximately 0.5-1%. Ultrasound guidance has likely reduced this further, though the pleura remains in close proximity. Meta-analyses report an overall rate of approximately 0.5%. The paravertebral space is bounded anterolaterally by the parietal pleura, and needle advancement beyond the transverse process risks pleural puncture. A post-procedural CXR is not routinely required if there are no clinical concerns.

Reference: RCOA – 2023 – Regional anaesthesia module; Naja Z – 2011 – Paravertebral block complications