Thoracic paravertebral block have been successfully used to provide analgesia for multiple thoracic and abdominal procedures in both children and adults.Several different techniques exist for TPVB; the classical technique, the use of nerve stimulator and ultrasound guidance Complications of thoracic paravertebral block include inadvertent needle penetration of adjacent structures, local anesthetic toxicity, complications due to distribution of local anesthetic and failure technique. Peripheral application of local anesthetics can be a useful adjunct in the treatment of acute postoperative pain. Surgical wound infiltration for relief of post thoracotomy pain has been shown to improve forced vital capacity and to have morphine-sparing effect. Local anesthetics interfere with impulse generation and propagation by blocking membrane permeability to sodium. Local anesthetic toxicity: allergy, neurotoxicity, cardio toxicity and CNS toxicity.