Scholarlink

Background <p>Postoperative analgesia after open liver resection is challenging owing to both somatic and visceral pain. Retro-superior costotransverse ligament block is a novel ultrasound-guided paraspinal block that may provide a safer and effective alternative to thoracic epidural analgesia, thoracic paravertebral block, and erector spinae plane block, particularly in patients with coagulation concerns.</p> Case presentation <p>A 38-year-old Han Chinese woman underwent open liver resection under general anesthesia. Preoperatively, ultrasound-guided retro-superior costotransverse ligament block was performed at the T6–7, T8–9, and T10–11 levels, with 10&#xa0;mL of a bupivacaine mixture injected per level (total 30&#xa0;mL: 20&#xa0;mL of liposomal bupivacaine and 10&#xa0;mL of plain bupivacaine).The patient achieved sensory blockade from T4 to T12 in the anterior and lateral thoracic wall, and from T3 to L1 posteriorly. Intraoperative hemodynamics remained stable. Postoperatively, visual analog scale scores for both resting and coughing remained between 0 and 2 for 48&#xa0;h. No rescue analgesics were required, and the patient-controlled analgesia pump was not activated.</p> Conclusion <p>Retro-superior costotransverse ligament block with liposomal bupivacaine may provide effective, long-lasting, and opioid-sparing analgesia after major abdominal surgery, and is a promising option.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Multilevel retro-superior costotransverse ligament block with liposomal bupivacaine for open hepatectomy: a case report

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年12月12日

查看全文
  • Hao Cheng,
  • Leiming Ding,
  • Kun Zhang,
  • Sufang Yang,
  • Chuanguang Wang,
  • Kailai Zhu

摘要

Background

Postoperative analgesia after open liver resection is challenging owing to both somatic and visceral pain. Retro-superior costotransverse ligament block is a novel ultrasound-guided paraspinal block that may provide a safer and effective alternative to thoracic epidural analgesia, thoracic paravertebral block, and erector spinae plane block, particularly in patients with coagulation concerns.

Case presentation

A 38-year-old Han Chinese woman underwent open liver resection under general anesthesia. Preoperatively, ultrasound-guided retro-superior costotransverse ligament block was performed at the T6–7, T8–9, and T10–11 levels, with 10 mL of a bupivacaine mixture injected per level (total 30 mL: 20 mL of liposomal bupivacaine and 10 mL of plain bupivacaine).The patient achieved sensory blockade from T4 to T12 in the anterior and lateral thoracic wall, and from T3 to L1 posteriorly. Intraoperative hemodynamics remained stable. Postoperatively, visual analog scale scores for both resting and coughing remained between 0 and 2 for 48 h. No rescue analgesics were required, and the patient-controlled analgesia pump was not activated.

Conclusion

Retro-superior costotransverse ligament block with liposomal bupivacaine may provide effective, long-lasting, and opioid-sparing analgesia after major abdominal surgery, and is a promising option.