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THORACIC WALL ANATOMY
Muscle layers
Spinal / intercostal nerves
Muscles of the back
The intertransverse connective tissue complex
Conceptual view of ESP and the paravertebral space
HOW DOES THE ESP BLOCK WORK?
1-The costotransverse foramen
2-The intertransverse connective tissue complex
Conceptual view of the ESP block
SONOANATOMY OF THE ESP BLOCK
The T5 transverse view
The T5 sagittal paramedian view
THE ESP BLOCK APPROACH
HOW TO PERFORM AN ESP BLOCK
Before starting
Patient position
T5 transverse scanning in real-time
T5 sagittal paramedian scanning medial-to-lateral in real-time
T5 sagittal paramedian scanning lateral-to-medial in real-time
In-plane approach to the ESP block in real-time
INDICATIONS FOR THE ESP BLOCK
KEY POINTS
TIPS