Thoracic paravertebral block (TPVB) can provide effective analgesia in the early postoperative period. Recent studies have shown that the use of local anesthetics combined with adjuvant drugs prolongs sensory or motor block time and improves postoperative pain scores. This article summarizes the clinical effects, dosages, mechanism of action, safety and effectiveness of different local anesthetic adjuvants when used in TPVB, which helps to clarify the clinical significance of adjuvant drugs used in TPVB. In the meantime, it is also helpful to find a reasonable drug compatibility and dosage, enhance the analgesic effect of TPVB, extend the duration of analgesia, and accelerate the rapid recovery of patients after surgery, providing a new reference for clinical anesthesia analgesia.