Article Text

Download PDFPDF

#36380 Sensory block dynamics of a multi-level intertransverse process block at the retro-sctl space: a case series
  1. Ranjith Kumar Sivakumar1,
  2. Manoj Kumar Karmakar2 and
  3. Cheuk Man Cheung2
  1. 1Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
  2. 2Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, Hong Kong


Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submission

Background and Aims This study evaluated sensory block dynamics of the recently described intertransverse process block (ITPB) at the retro-SCTL space.

Methods After ethics approval and informed consent, 11 patients aged 18-80 years, ASA I-III, scheduled for unilateral video-assisted thoracoscopic surgery received an ultrasound-guided (USG) ITPB at the retro-SCTL space. The ITPB was performed at three levels (T3, T5, T7) and 6 ml of a 1:1 mixture of 2% lignocaine with 1:200,000 adrenaline and 0.5% levobupivacaine was injected at each level. The sensory block was assessed bilaterally, along the midclavicular and mid-scapular line, and from T2 to L3 dermatomes using a numeric rating scale (NRS 0-100; 100-normal sensation, 0-no sensation to cold) for 30 minutes after the block and in the recovery room (RR). All patients received general anaesthesia and a multimodal analgesia regime for postoperative pain relief.

Results The USG three-level ITPB at the retro-SCTL space produced bilateral thoracic anaesthesia (figure 1). The median [IQR] number of dermatomes affected on the ipsilateral and contralateral thorax is presented in figure 1. Significantly more dermatomes, both anterior (p=0.01) and posterior (p=0.02), were affected on the ipsilateral than the contralateral thorax. In the RR, the sensation of cold over the thorax had returned to an NRS

>50/100, bilaterally, in the majority of patients (91%). Nevertheless, all patients remained comfortable.

Abstract #36380 Figure 1

Thoracic dermatomal anaesthesia after a multilevel intertransverse process block at the retro-SCTL space. Data are presented as a median [IQR]

Conclusions A multilevel ITPB at the retro-SCTL space produces bilateral thoracic anesthesia but more dermatomes are affected over the ipsilateral than contralateral thorax. Future research to evaluate its anaesthetic and analgesic potential is warranted.

Attachment CREC approval (2021.560 ).pdf

  • intertransverse process block
  • thoracic paraspinal block
  • thoracic fascial plane block
  • retro-SCTL space
  • superior costotransverse ligament

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.