A Novel Intertransverse Plane Block: a Magnetic Resonance Imaging and Volunteer Study

Mahidol University

Status: Completed

Conditions: Intertransverse Process Block; Thoracic Paravertebral Block; Thoracic Nerve Block

Treatments: Procedure: Intertransverse process block

Study type: Interventional

Funder types: Other

Identifiers

NCT05538884

Si 267/2022

Details and patient eligibility

About

Intertransverse process block (ITPB) is a thoracic nerve block technique where the LA is injected into the thoracic "intertransverse tissue complex" posterior to the superior costotransverse ligament (SCTL). It may be an attractive alternative to a TPVB for unilateral surgery on the thorax, when considering the risk for pleural puncture, since it does not require direct needle access to the thoracic paravertebral space. However, although ITPB is ultrasound guided, the LA is frequently injected using surrogate bony landmarks in the sagittal sonogram, and in most cases without even identifying the SCTL.

Full description

The knowledge regarding the spread of local anesthetic is a major prerequisite for a safe and effective use of all regional anesthetic methods in clinical practice. The primary outcome is the spread of injectate which will be evaluated on axial three-dimensional MRI with contrast medium. The secondary outcome is the sensory dermatomal blockade of this novel ITPB block.

Enrollment: 10 patients

Sex: Male

Ages: 18 to 50 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• healthy Thai men with no diseases

Exclusion criteria

• inability to cooperate or communicate in Thai
• BMI ≥ 30 kg/m2 or body weight ≤ 45 kgs
• allergy to local anesthetics or contrast agents
• infection in the block area
• previous surgery or anatomical abnormalities of thoracic spines closed to block area
• coagulation disorder/thrombocytopenia/anticoagulation therapy
• contraindications to magnetic resonance imaging (MRI) (metal implants - pacemaker and others, claustrophobia)

Trial design

Primary purpose: Diagnostic

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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10 participants in 1 patient group

Intertransverse process block

Experimental group

Description:

Using a simple transverse ultrasound imaging technique to visualize the superior costotransverse ligament (SCTL) and the retro-SCTL space, we can perform a novel ITPB. Local anesthetic will be injected at the retro SCTL space.

Treatment:

Procedure: Intertransverse process block