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. 2022 Apr 4;75(4):295–306. doi: 10.4097/kja.22138

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Copyright © The Korean Society of Anesthesiologists, 2022

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Fig. 3. — Ultrasound images of the paravertebral space and anatomical structures relevant to a paraspinal block at the mid-thoracic region. (A) A transverse scan to identify bony landmarks. (B) A transverse scan to perform a paravertebral block (PVB). (C) A parasagittal scan to perform a retrolaminar block (RLB). (D) A parasagittal scan of the intertransverse process (ITP) region. Illustrations in the right corner show the probe locations in each ultrasound image. Arrows indicate the erector spinae fascial plane (ESP), and arrowheads indicate the superior costotransverse ligament (SCTL). As shown in Fig. 3D, the erector spinae fascial plane is the target for an ESP block, the tissue complex posterior to the SCTL (retro-SCTL space) is the target for an ITP block, and the TPVS is directly targeted for the PVB. ES: erector spinae muscles, L: vertebral lamina, ICM: intercostal muscles, TP: transverse process, SP: spinous process, P: pleura, TPVS: thoracic paravertebral space, RS: retro-SCTL space.