MTP Block -holy grail for chronic pleuritic pain – The silver lining in the dark clouds- A case report

Abstract

Intercostal nerves innervate the pleura, and pain is localized to its cutaneous distribution, i.e. T1–T11 thoracic dermatomes. In the present case report, a 62-year-old male patient had chronic pain over T8–T9 dermatomes over the left posterolateral chest wall; postmultiple empyema drainage, which was successfully managed with mid transverse plane (MTP) block along with a multimodal analgesic regimen. Chronic pain, if not managed, leads to poor quality of life and debilitation. The MTP block is given between the transverse process and the pleura with reliable spread to the paravertebral space across the costotransverse ligament. A single-site injection can achieve adequate analgesia of the entire hemithorax at a particular dermatomal level. MTP can be an authentic option for patients with acute or chronic thoracic pain postoperatively or traumatic rib fractures with reliable results.