Right Breast Mastectomy and Reconstruction with Tissue Expander under Thoracic Paravertebral Blocks in a 12-Week Parturient

Figure 1

Using a linear transducer (10–5 MHz, Sonosite Bothel, WA), a paramedian oblique sagittal scan was used to obtain the view of the transverse processes. A slight lateral tilt was applied to optimize visualization of the pleural lining (white asterisk). The needle was advanced in a caudal to cranial direction until the tip was placed underneath the costotransverse ligament. After negative aspiration, hydrodissection with saline was used and anterior displacement of the pleura was confirmed. TP = transverse process. Blue arrow delineates needle trajectory. The white asterisk represents the pleura.