Intertransverse Process Block, Thoracic Nerve Block, Thoracic Paravertebral Block
Conditions
Keywords
MRI study, Volunteer study
Brief summary
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.
Detailed 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.
Interventions
PROCEDUREIntertransverse process block
The ITPB block at T5-6 will be performed with a mixture of local anesthetic with MRI contrast 0.5% bupivacaine 10 ml and 0.5 ml contrast in concentration 3.09 mmol/l. Volunteers will be moved to MRI machine and imaged in a supine position for their whole thoracic spine. This process will last about 45-60 minutes.
Sponsors
Mahidol University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Intervention model description
The ITPB block at T5-6 level will be performed with a mixture of local anesthetic with MRI contrast 0.5% bupivacaine 10 ml and 0.5 ml contrast in concentration 3.09 mmol/l. Volunteers will be moved to MRI machine and imaged in a supine position for their whole thoracic spine.
Eligibility
Sex/Gender
MALE
Age
18 Years to 50 Years
Healthy volunteers
Yes
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)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Local anesthetic spreading from MRI image | 1 month | Using local anesthetic mixed with contrast |
Countries
Thailand
Outcome results
None listed