Lesson 53, Topic 4
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53.4 Landmarks & patient position

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The patient is best positioned in a sitting, lateral decubitus or prone position. Identify the desired level for injection by counting down from the first rib (with the ultrasound), or by taking into account the bony landmarks of the back, and their corresponding vertebral levels.

Taking into account that local anesthetic spreads in a craniocaudal way; the targeted transverse process (level for the block) should be a central point according to the required levels for analgesia.
Patient in a sitting position for an ESPB.