Porcine carcass phantom for ultrasound imaging and hands-on practice in needle insertion in the thoracic paravertebral space.

摘要

To the Editor,Thoracic paravertebral block (PVB) provides excellent surgical anesthesia as well as postoperative analgesia for thoracic surgeries.Several ultrasound-guided PVB techniques have been described using either a transverse scan or a parasagittal scan in both the in-plane and the out-of-plane needle insertion approaches.The different approaches rely on the identification of one of two landmarks: 1) the superior costotransverse ligament (SCTL) or 2) the internal intercostal membrane (IICM). Learning to scan and identify the SCTL and IICM is possible on volunteers or patients, but, ideally, proficiency of hands-on needle insertion skills is acquired on phantoms prior to patient care given the potential risks of epidural or intra-thecal spread, accidental pleural puncture, and pneumothorax associated with thoracic PVB. It is well known that phantom practice can shorten the learning curve, reduce complications, and result in changes in clinical practice.