Published in:
01-08-2018 | Correspondence
Analgesia-related differences among the erector spinae, multifidus cervicis, and inter-semispinal plane blocks
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 8/2018
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To the Editor,
Figure
Transverse ultrasonographic view of the semispinalis capitis muscle visualized at the level of the fifth cervical vertebra (panel A) and the third thoracic vertebra (panel B). Numbers show the sonographic targets of blocks of the third thoracic vertebra transverse process in the erector spinae plane (arrow 1), multifidus cervicis plane (arrow 2), and inter-semispinal plane (arrow 3). Arrow 4 shows the plane where the local anesthetic was identified in the case of Forero et al. Panel C shows cadaver dissection after injection of 20 mL of blue dye into the inter-semispinal plane (both sides) and 20 mL of yellow dye into the erector spinae plane (right). The blue dye is visible on the semispinalis capitis muscle (red line) but does not leak outside the muscle. The yellow dye spreads alongside the inverted longissimus muscle (*). These dyes exist separately. The dashed line shows the dorsal midline, and the double asterisk (**) shows the splenius capitis and splenius cervicis muscles (inverted). L = longissimus muscle; M = multifidus cervicis muscle; SCA = semispinalis capitis muscle; SCE = semispinalis cervicis muscle; SP = spinous process; TP = transverse process
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