{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:09:36Z","timestamp":1791544176664,"version":"4.3.4"},"reference-count":15,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,8,1]],"date-time":"2017-08-01T00:00:00Z","timestamp":1501545600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Current descriptions of thoracic paravertebral block techniques require the needle tip to be anterior to the superior costotransverse ligament. We hypothesised that an injection point midway between the posterior border of the transverse process and the pleura would result in spread to the paravertebral space. We completed bilateral injections of 5\n                    <jats:styled-content style=\"fixed-case\">ml<\/jats:styled-content>\n                    methylene blue 0.2% midway between the posterior border of the transverse process and the pleura at T2, T4, T6, T8 and T10 in three unembalmed cadavers. The presence of methylene blue dye at the nerve root in the paravertebral space, the corresponding intercostal nerve and sympathetic chain at the level of injection, and at additional levels, was examined. We identified the superior costotransverse ligament, pleural displacement and spread to the erector spinae plane. We describe two case reports using this technique in patients. Our cadaver results and clinical cases demonstrate that, with the exception of cadaver 1, an injection point midway between the posterior border of the transverse process and pleura consistently achieved spread of dye at least to the paravertebral space at the level of injection, and frequently to adjacent levels. This may be a plausible explanation for the landmark technique's inability to reliably achieve a multilevel block. We describe a new ultrasound\u2010guided technique for a single level paravertebral block.\n                  <\/jats:p>","DOI":"10.1111\/anae.14004","type":"journal-article","created":{"date-parts":[[2017,8,1]],"date-time":"2017-08-01T07:52:36Z","timestamp":1501573956000},"page":"1230-1236","source":"Crossref","is-referenced-by-count":180,"title":["The mid\u2010point transverse process to pleura (\n                    <scp>MTP<\/scp>\n                    ) block: a new end\u2010point for thoracic paravertebral block"],"prefix":"10.1111","volume":"72","author":[{"given":"I.","family":"Costache","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine The Ottawa Hospital University of Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"de Neumann","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine The Ottawa Hospital University of Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. J.","family":"Ramnanan","sequence":"additional","affiliation":[{"name":"Department of Innovation in Medical Education Division of Clinical and Functional Anatomy Faculty of Medicine University of Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. L.","family":"Goodwin","sequence":"additional","affiliation":[{"name":"Department of Innovation in Medical Education Division of Clinical and Functional Anatomy Faculty of Medicine University of Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Pawa","sequence":"additional","affiliation":[{"name":"Guy's and St Thomas' NHS Foundation Trust UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. W.","family":"Abdallah","sequence":"additional","affiliation":[{"name":"St Michael's Hospital Li Ka Shing Knowledge Institute University of Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. J. L.","family":"McCartney","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine The Ottawa Hospital University of Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,8]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1979.tb06363.x"},{"key":"e_1_2_7_3_1","volume-title":"Clinical anatomy of the spine, spinal cord, and ANS","author":"Cramer GD","year":"2014"},{"key":"e_1_2_7_4_1","volume-title":"Clinically oriented anatomy","author":"Moore KL","year":"2013"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000747"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000451"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13814"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00540-016-2230-1"},{"key":"e_1_2_7_9_1","first-page":"110","article-title":"Intercostal\/paraspinal nerve block for thoracic surgery","volume":"71","author":"Roue C","year":"2015","journal-title":"Anaesthesia"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13527"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aep015"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00115550-200411000-00013"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199412000-00015"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200109000-00033"},{"key":"e_1_2_7_15_1","volume-title":"Incidence of successful paravertebral block using landmark technique in a phantom model","author":"Samee I"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2008.05843.x"}],"container-title":["Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fanae.14004","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anae.14004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T19:24:26Z","timestamp":1761679466000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1111\/anae.14004"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8]]},"references-count":15,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2017,10]]}},"alternative-id":["10.1111\/anae.14004"],"URL":"https:\/\/doi.org\/10.1111\/anae.14004","archive":["Portico"],"relation":{},"ISSN":["0003-2409","1365-2044"],"issn-type":[{"value":"0003-2409","type":"print"},{"value":"1365-2044","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8]]}}}