Retrolaminar Block vs Paravertebral Block for Pain Relief

Woman receiving a nerve block


Complete pain control while a patient is undergoing an operation while conscious is essential to successfully completing that surgery. Nerve blocks have long been used as an effective method in cases like this. The most well-known form of nerve block is the epidural, which is often selected by women giving birth to control their pain. A nerve block refers to a procedure where an injection of local anesthetic is made near a nerve bundle or other effective area. The anesthetic serves to numb the nerve and limit or eliminate its ability to communicate pain signals to the brain, effectively controlling discomfort. Paravertebral and retrolaminar blocks are other nerve block forms used to control pain during a surgical treatment. 


What Are Paravertebral Blocks, and Retrolaminar Blocks

A paravertebral block is a pain management technique involving the injection of a local anesthetic into the spine. The injection is made into the space between the vertebrae and the spinal nerves, where they emerge from the intervertebral foramen. This is a portal between the peripheral nervous system and the spinal canal and can be found at all spine levels. These types of blocks are considered to be highly effective and can provide analgesia (numbing) for major surgeries at a variety of locations in the body. These injections can be made at any point along the spine, from the lumbar (base), through the thoracic (abdomen and chest), and through to the cervical (neck) vertebrae. 


This type of nerve block is often preferred over an epidural block for the following reasons:

  • Similar pain relief with less frequent side-effects
  • Improved pulmonary (lung) function and complications 
  • They Can be used where a thoracic epidural block in cases where it is contraindicated (hazardous to use)


A retrolaminar block (RLB) is a variation of the above anesthetic approach. An RLB injects the anesthetic into an area known as the retrolaminar plane. In studies performed using this approach, the pain relief achieved has been similar to or greater than that achieved with a standard paravertebral block. Additionally, the time to perform this form of the block was less than that of a paravertebral block, reducing the overall time the procedure takes to perform. An RLB is not always able to be performed based on a variety of factors that can make the area more difficult to reach.


Consult With Your Specialist About PVB or RLB 

In addition to being an effective form of pain relief during surgical treatment, nerve blocks can be used as a diagnostic tool. Numbing a portion of the nervous system can help isolate the source of pain and inform the physician about what kinds of treatment may be effective. If you want to learn more about this and other forms of pain control, reach out to your spinal or pain management specialist. They’ll go over the details and discuss how these treatments are used at their practice.


Dr. Todd A. Bromberg, M.D. When chronic pain and spinal issues impact your quality of life, you need a team of crack spine and pain specialists at your disposal. Delaware Valley Pain & Spine Institute works with some of the most respected experts in the field to bring pain relief and restored quality of life to patients in Pennsylvania and New Jersey!
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