Objective · To observe the effects of ultrasound guided and nerve stimulator located thoracic paravertebral nerve block (TPVB) for patients undergoing intercostal nerve transfer surgery on postoperative pain relief, complications, and hemodynamics. Methods · Sixty patients undergoing intercostal nerve transfer surgery were recruited and randomly assigned to receiving TPVB analgesia (Group T) and intravenous analgesia (Group V) with 30 patients in each group. Group T received thoracic paravertebral block guided by ultrasound and located by nerve stimulator. 20 mL of 0.375% ropivacaine with 5 mg of dexamethasone were injected into the thoracic paravertebral space of T4-T5. Changes in arterial pressure and heart rate were observed, and the range of intercostal nerve block and complications were recorded. Group V received intravenous analgesia after operation on demand. Visual analogue scale (VAS) scores 6 h and 12 h after surgery were recorded and compared between groups. Results · Five dermatome segments of intercostal nerve between T3 and T7 at surgical side were blocked. No complications and significant changes in arterial pressure and heart rate were observed. The VAS scores 6 h after surgery were significantly lower in Group T than in Group V (P=0.001). The differences in VAS scores 12 h after surgery between two groups were not statistically significant. Conclusion · Ultrasound guided and nerve stimulator located TPVB is easy and safe to perform and provides wide range of intercostal nerve block with less complications and perfect analgesia. It is especially applicable to pain relief after the intercostal nerve transfer surgery for patients with severe pain.