Brown-Séquard Paralysis Following a Paravertebral Alcohol Injection for Angina Pectoris

Thoracic paravertebral block

“…93 The most serious complication ever reported was a Brown Séquard paralysis which followed the use of paravertebral alcohol for the treatment of angina pectoris in 1931. 57 At that time, this frequently used destructive treatment would not have involved radiological screening. 102 Accidental extradural injection is a rare event 51 71 which indicates a faulty technique.…”

Serratus plane block: do we need to learn another technique for thoracic wall blockade?

“…Using the multiple‐injection caudad approach, no pneumothoraces were reported in a series of over 1000 patients and the relative risk compared with general anaesthesia alone was 0.01 . In two recent editorials, it has been strongly suggested that there is a significant risk of neurological damage with paravertebral block , but there have been no reports in association with breast surgery and overall only five cases have been published, four of which were over 50 years ago, one with alcohol and three with Efocaine . Efocaine was subsequently withdrawn because of neurological toxicity .…”

Lest we forget: learning and remembering in clinical practice

“…Using the multiple-injection caudad approach, no pneumothoraces were reported in a series of over 1000 patients [32] and the relative risk compared with general anaesthesia alone was 0.01 [6]. In two recent editorials, it has been strongly suggested that there is a significant risk of neurological damage with paravertebral block [30,33], but there have been no reports in association with breast surgery and overall only five cases have been published, four of which were over 50 years ago, one with alcohol [34] and three with Efocaine [35]. Efocaine was subsequently withdrawn because of neurological toxicity [36].…”