{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:34:29Z","timestamp":1787762069147,"version":"build-2784847793"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Among the various regional anesthesia techniques used for postoperative analgesia in the modified radical mastectomy (MRM), thoracic paravertebral block (TPVB) is presently considered the technique of choice. Nevertheless, TPVB may lead to complications like inadvertent vascular puncture, hypotension, epidural or intrathecal spread, pleural puncture, or pneumothorax. Recently, a newer technique \u201cmidpoint transverse process to pleura\u201d (MTP) block has been described in which the tip of the needle is placed at the midpoint between the transverse process and pleura. In this case series, we included ten patients of American Society of Anesthesiologist status I\/II scheduled for MRM. Ultrasound-guided MTP block was performed and the catheter was inserted on the side of the surgery at the level of T4 level. The block was successful in the all patients as their median visual analogue score at rest and movement was 2 and 3, respectively, in first 24 h postoperatively. Only three patients required rescue analgesia in the first 24 h. No procedural-related complications were noticed in any patient. We concluded that MTP block provided effective perioperative analgesia with minimal rescue analgesia requirement and satisfactory safety profile.<\/jats:p>","DOI":"10.4103\/joacp.joacp_147_22","type":"journal-article","created":{"date-parts":[[2023,7,31]],"date-time":"2023-07-31T14:25:40Z","timestamp":1690813540000},"page":"648-650","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["The midpoint transverse process to pleura (MTP) block for postoperative analgesia in patients undergoing modified radical mastectomy: A case series"],"prefix":"10.4103","volume":"39","author":[{"given":"Rakesh","family":"Kumar","sequence":"first","affiliation":[{"name":"Departments of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadik","family":"Mohammed","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bharat","family":"Paliwal","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoj","family":"Kamal","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swati","family":"Chhabra","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pradeep","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashmi","family":"Syal","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Dr S.N. Medical College, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,7,29]]},"reference":[{"key":"R2-20240828","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1097\/AJP.0b013e3181dee988","article-title":"Severity of acute pain after breast surgery is associated with the likelihood of subsequently developing persistent pain","volume":"26","author":"Hickey","year":"2010","journal-title":"Clin J Pain"},{"key":"R3-20240828","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1590\/S0034-70942008000600001","article-title":"Comparative study between thoracic epidural block and general anesthesia for oncologic mastectomy","volume":"58","author":"Belzarena","year":"2008","journal-title":"Rev Bras Anestesiol"},{"key":"R4-20240828","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1093\/bja\/aeq265","article-title":"Efficacy and safety of paravertebral blocks in breast surgery:A meta-analysis of randomized controlled trials","volume":"105","author":"Schnabel","year":"2010","journal-title":"Br J Anaesth"},{"key":"R5-20240828","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1016\/j.redar.2012.07.003","article-title":"Ultrasound description of Pecs II (modified Pecs I):A novel approach to breast surgery","volume":"59","author":"Blanco","year":"2012","journal-title":"Rev Esp Anestesiol Reanim"},{"key":"R6-20240828","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1097\/00000539-200006000-00026","article-title":"Thoracic paravertebral block for breast surgery","volume":"90","author":"Klein","year":"2000","journal-title":"Anesth Analg"},{"key":"R7-20240828","doi-asserted-by":"crossref","first-page":"5","DOI":"10.4103\/0970-9185.76608","article-title":"Paravertebral block","volume":"27","author":"Batra","year":"2011","journal-title":"J Anaesthesiol Clin Pharmacol"},{"key":"R8-20240828","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1111\/anae.14004","article-title":"The mid-point transverse process to pleura (MTP) block:A new end-point for thoracic paravertebral block","volume":"72","author":"Costache","year":"2017","journal-title":"Anaesthesia"},{"key":"R9-20240828","doi-asserted-by":"crossref","first-page":"365","DOI":"10.4103\/sja.SJA_773_18","article-title":"Novel block and new indication:Ultrasound-guided continuous \u201cmid-point transverse process to pleura\u201dblock in a patient with multiple rib fractures","volume":"13","author":"Syal","year":"2019","journal-title":"Saudi J Anaesth"},{"key":"R10-20240828","doi-asserted-by":"crossref","first-page":"512","DOI":"10.4103\/ija.IJA_64_21","article-title":"Comparison of analgesic efficacy of the conventional approach and mid-transverse process to pleura approach of the paravertebral block in video-assisted thoracoscopy surgeries:A randomised controlled trial","volume":"65","author":"Swathi","year":"2021","journal-title":"Indian J Anaesth"},{"key":"R11-20240828","doi-asserted-by":"crossref","first-page":"245","DOI":"10.4103\/ija.IJA_728_18","article-title":"Use of the mid-transverse process to pleura block in a patient undergoing intercostal drain placement and rib resection","volume":"63","author":"Sharma","year":"2019","journal-title":"Indian J Anaesth"},{"key":"R12-20240828","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1007\/s00101-020-00848-w","article-title":"Ultrasound-guided erector spinae block versus mid-transverse process to pleura block for postoperative analgesia in lumbar spinal surgery","volume":"69","author":"Eskin","year":"2020","journal-title":"Anaesthesist"}],"container-title":["Journal of Anaesthesiology Clinical Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/joacp.joacp_147_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:17:06Z","timestamp":1787761026000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/joacp.joacp_147_22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,29]]},"references-count":11,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/joacp.joacp_147_22","relation":{},"ISSN":["0970-9185","2231-2730"],"issn-type":[{"value":"0970-9185","type":"print"},{"value":"2231-2730","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,29]]},"assertion":[{"value":"2022-04-19","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-22","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}