Sole thoracic paravertebral block for excision of chest wall lipoma in a patient with atrial septal defect: A Case Report

Thoracic Para Vertebral Block (TPVB) is one of the Regional Anaesthesia (RA) methods indicated for acute and chronic pain management as well as a sole technique for chest wall surgeries like lumpectomy, mastectomy. Being unilateral it has distinct advantage of minimal hemodynamic effects. Patients with cardiopulmonary comprise are reported to tolerate surgical management of chest wall pathologies very well under TPVB.I report a case of atrial septal defect (ASD) with pulmonary hypertension having lipoma over right infra axillary region for excision. Single needle TPVB was given at the level of T4 using 18G Tuohy’s epidural needle and Loss of Resistance (LOR) technique. An 18G catheter was passed 3cm inside the para vertebral space. Excellent anaesthesia was produced over C8 to T7 region and the surgery was uneventful. Thus sole TPVB is a good option for unilateral surgeries of chest wall especially in patients with cardiopulmonary dysfunction.