Fig. 15.
Ultrasound (US)-guided thoracic paravertebral blocks using a sagittal transducer. (A) Oblique sagittal cross-section at thoracic level T4/T5 at approximately 5 cm lateral of the midline. The superior costotransverse ligament (SCTL) (pink) is highlighted by a dotted outline. (B) Illustration depicting transducer position and needle trajectory for a medial technique with caudolateral to craniomedial angulation (7). The arrow number refers to figure 5. A = anterior; es = erector spinae muscle; I = inferior; in = intercostal nerve; lc = levator costarum muscle; P = posterior; r = rib; rhomb = rhomboid muscle; S = superior; ST = sympathetic trunk; TP = transverse process; trap = trapezius muscle; turquoise = costotransverse ligament. Red, blue, and yellow indicate artery, vein, and nerve, respectively.