Open AccessNovel block and new indication: Ultrasound-guided continuous “mid-point transverse process to pleura” block in a patient with multiple rib fractures
Author(s) -
Rashmi Syal,
Rakesh Kumar,
Manoj Kamal,
Pradeep Bhatia
Publication year - 2019
Publication title -
saudi journal of anaesthesia (online)
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.416
H-Index - 24
eISSN - 1658-354X
pISSN - 0975-3125
DOI - 10.4103/sja.sja_773_18
Subject(s) - medicine , block (permutation group theory) , ropivacaine , surgery , epidural block , parietal pleura , anesthesia , lung , geometry , mathematics
To avoid the complications related to thoracic epidural and paravertebral block, we performed mid-point transverse process to pleura (MTP) block in a patient with multiple rib fractures. A patient with 2 nd --5 th rib fractures came with complains of severe pain and difficulty in breathing. Ultrasound (US)-guided continuous MTP block was given at T4 level and 15 ml of 0.375% ropivacaine was deposited, followed by the catheter insertion at the same level. Patient reported decreased sensation from T2--T8 dermatomes and reduced VAS scores from 9/10 to 1/10 within 20 min of block insertion. Continuous MTP block is efficacious in providing thoracic analgesia and has higher safety margin as needle is inserted further away from pleura.