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INTRODUCTION Radiologically inserted gastrostomy (RIG) placement in patients with amyotrophic lateral sclerosis (ALS) carries risks related to periprocedural sedation and analgesia. To minimize these risks, we used a paravertebral block (PV technique for RIG placement. METHODS We retrospectively reviewed patients with ALS undergoing RIG placement under PVB between 2013 and 2017. RESULTS Ninety-nine patients with ALS underwent RIG placement under PVB. Median (range) age was 66 (28 to 86) years, ALS Functional Rating Scale-Revised score