TPV block
THORACIC, LOCAL INFILTRATION
TPV Block was performed on two thoracic (T) levels (T2- T3 and T4-T5); ultrasound guidance was used to visualize the superior costo-transverse ligament and the pleura as hyperechoic structures, and the paravertebral space was visualized as a wedge-shaped hypoechoic layer between these structures (Fig. Thoracic paravertebral space, before (After local infiltration with 2.0 mL of 2% lignocaine at the site of puncture, the block was performed at two thoracic levels, and for each level 8 mL of 0.75% ropivacaine were injected (120 mg of Ropivacaine), not exceeding the toxic dose.The spread of local anesthetic in the paravertebral space and a concomitant anterior movement of the parietal pleura were observed using real-time image guidance.