Ultrasound-Guided Midpoint Transverse Process to Pleura Nerve Block for Medical Thoracoscopy: A Case Report

Area of Science:

• Anesthesiology
• Thoracic Surgery
• Pain Management

Background:

• Recurrent pleural effusion necessitates procedures like medical thoracoscopy, drainage, and catheter placement.
• Effective pain management is crucial for patient comfort and procedural success during thoracic interventions.
• Regional anesthesia techniques are increasingly explored for thoracic procedures.

Observation:

• A midpoint transverse process to pleura (MTP) block was administered to a patient undergoing medical thoracoscopy for recurrent pleural effusion.
• The procedure involved sedation and the left lateral decubitus position.
• Ultrasound guidance was utilized for precise needle placement at the T6 level.

Findings:

• A combination of bupivacaine hydrochloride and lidocaine, with dexamethasone and clonidine, was injected.
• Forty milliliters of the anesthetic mixture was administered.
• The MTP block resulted in satisfactory intraoperative and postoperative analgesia.

Implications:

• The MTP block represents a viable regional anesthesia option for patients undergoing thoracic procedures for pleural effusion.
• Ultrasound guidance enhances the safety and efficacy of MTP blocks.
• This technique may improve patient recovery and reduce the need for systemic opioids.