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a: Positioning and scanning during erector spinae plane (ESP) block. The needle is inserted in a cephalad-to-caudal direction; b: The needle (triangle indicates) is inserted through the trapezius muscle (TM), rhomboid major muscle (RMM) and Erector Spinae Muscle (ESM), to the transverse process; c: An injection at this point creates a linear pattern of local anesthetic spread (arrows) that displaces the ESM downward
