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Novel Block and New Indication: Ultrasound-guided Continuous "mid-point Transverse Process to Pleura" Block in a Patient with Multiple Rib Fractures

Overview
Journal Saudi J Anaesth
Specialty Anesthesiology
Date 2019 Oct 2
PMID 31572085
Citations 10
Authors
Rashmi Syal
Rakesh Kumar
Manoj Kamal
Pradeep Bhatia
Affiliations
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Abstract

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--5 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.

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