title: Thoracic paravertebral spread using two different ultrasound-guided intercostal injection techniques in human cadavers.
abstract: The continuity between the intercostal and paravertebral space has been established by several studies. In this study, the paravertebral spread of a colored dye was attempted with two different ultrasound-guided techniques. The posterior area of the trunk was scanned with a linear probe between the level of the fifth and the seventh thoracic vertebrae in eleven embalmed human cadavers. In the first technique, the probe was placed transversely below the inferior margin of the rib, and a needle was inserted between the internal intercostal membrane and the pleura. In the second technique, the probe was placed longitudinally at the intercostal space 5 cm lateral to the spinous processes, and the needle was inserted between the internal intercostal membrane and the pleura. In both techniques, 1 ml of methylene blue was injected, and both the intercostal and paravertebral spaces were prepared. In total, 33 injections were performed: 19 with the transverse technique and 14 with the longitudinal technique. Successful spread of the dye to the thoracic paravertebral space was recorded in 89.5% cases using the transverse technique and 92.8% cases using the longitudinal technique. No intrapleural spread of the dye was recorded in either technique. Ultrasound-guided injection into the intercostal space may offer an alternative approach to the thoracic paravertebral space.
authors.affiliation: Department of Anatomy, University of Athens, School of Medicine, Athens, Greece. tilepara@yahoo.gr.
authors.forename: Tilemachos
authors.initials: T
authors.lastname: Paraskeuopoulos
authors.forename: Theodosios
authors.initials: T
authors.lastname: Saranteas
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kouladouros
authors.forename: Heleni
authors.initials: H
authors.lastname: Krepi
authors.forename: Mariza
authors.initials: M
authors.lastname: Nakou
authors.forename: Georgia
authors.initials: G
authors.lastname: Kostopanagiotou
authors.forename: Sophia
authors.initials: S
authors.lastname: Anagnostopoulou
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000775:Anesthesia, Spinal; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D009407:Nerve Block / Q000379:methods*; D018084:Ultrasonography, Interventional