Title: Variability of a Thoracic Paraveretbral Block: Are we ignoring the Endothoracic Fascia?
Authors: Karmakar MK,Chung DC
Journal:Reg Anesth Pain Med 25: 325-7,2000

Letter. The variability which is reported in the spread of local anesthetics in the paravertebral space may depend on whether the injection is superficial or deep to the endothoracic fascia which divides the paravertebral space into two compartments.Due to attachments of this fascia to ribs and the vertebral bodies, injection into the subendothoracic compartment would be expected to spread more easily to other dermatomes and contralaterally. The thinness of this fascia ( 250 um) would make it difficult to identify during either open or percutaneous paravertebral block.