Study Comparing Local Anesthetic Spread Using Retro-superior Costotransverse Ligament Space Block and Thoracic Paravertebral Block with 3D CT Imaging

What this Trial Is About

This research aims to compare the spread and sensory block range of local anesthetics during two nerve block methods, retro-superior costotransverse ligament space block retro-SCTLB and thoracic paravertebral block TPVB, in patients undergoing CT-guided lung nodule localization. The study investigates differences in how these local anesthetics diffuse to various areas around the spine and chest in adults aged 18 to 80 years. Forty patients are randomly assigned to receive either the retro-SCTLB or TPVB nerve block under ultrasound guidance before their CT-guided lung nodule localization procedure. Both groups receive an injection of 20 ml of a local anesthetic solution 0.375% ropivacaine mixed with iohexol delivered within one minute. The retro-SCTLB involves injecting near the superior costotransverse ligament, while the TPVB targets the paravertebral space. Fifteen minutes after the nerve block, CT scans with three-dimensional reconstruction are performed to observe the anesthetic spread. Participants undergo assessments including CT imaging to measure the local anesthetic diffusion in multiple directions and spaces, such as the paravertebral, intercostal, epidural spaces, and areas around vertebrae. Sensory block is evaluated using skin tests with ice. The study monitors the spread of anesthesia and sensory effects at 15 minutes post-block, with safety and side effects also observed. The total participation spans from nerve block administration through imaging and sensory evaluation within the study period.

Local Anaesthetic Spread and Sensory Block Range of the Retro-superior Costotransverse Ligament Space Block