CASE REPORT
Year : 2019  |  Volume : 13  |  Issue : 4  |  Page : 365-367

Novel block and new indication: Ultrasound-guided continuous “mid-point transverse process to pleura” block in a patient with multiple rib fractures


Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

Correspondence Address:
Dr. Rashmi Syal
Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur - 342 005, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sja.SJA_773_18

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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 2nd--5th 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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