case_images: PMC10876124_01
case_images: Pre-operative chest roentgenogram showing thoracolumbar scoliosis with Cobb's angle of 60 degrees
case_images: ACA-27-61-g001.jpg
case_images: PMC10876124_01_ACA-27-61-g001.jpg
case_images: aca_47_23-f001
case_images: Additionally, she had thoracolumbar scoliosis (Cobb's angle 60 degrees) [Figure 1] and Mayer-Rokitansky-Kuster-Hauser syndrome.
case_images: PMC10876124_02
case_images: The ultrasound image showing out of the plane technique for Tuohy's needle placement between the inner intercostal and transverses thoracic muscles, depositing the ropivacaine between transverse abdominis muscle and transversalis fascia on the right side (IIM: Internal intercostal muscle; PM: Pectoralis major; TTM: Transversus thoracic muscle)
case_images: ACA-27-61-g002.jpg
case_images: PMC10876124_02_ACA-27-61-g002.jpg
case_images: aca_47_23-f002
case_images: Fujifilm M-Turbo) was placed atfourth intercostal space 1 cm lateral to the sternum and the internal intercostal, transversus thoracic, internal thoracic artery, and vein were identified. For the right side, the probe was positioned longitudinally [Figure 2] and transversely on the left side [Figure 3].
case_images: The ultrasound image showing an in-plane technique for Tuohy's needle placement between the inner intercostal and transverses thoracic muscles, depositing the ropivacaine between transverse abdominis muscle and transversalis fascia on the left side (IIM: Internal intercostal muscle; PM: Pectoralis major; TTM: Transversus thoracic muscle)
case_images: ACA-27-61-g003.jpg
case_images: PMC10876124_02_ACA-27-61-g003.jpg
case_images: aca_47_23-f003
case_images: Fujifilm M-Turbo) was placed atfourth intercostal space 1 cm lateral to the sternum and the internal intercostal, transversus thoracic, internal thoracic artery, and vein were identified. For the right side, the probe was positioned longitudinally [Figure 2] and transversely on the left side [Figure 3].
case_images: Final arrangement with bilateral catheters connected at the distal end with three-way connectors
case_images: ACA-27-61-g004.jpg
case_images: PMC10876124_02_ACA-27-61-g004.jpg
case_images: aca_47_23-f004
case_images: The post-operative analgesia was planned as a continuous infusion of 0.2% ropivacaine at 10 ml/hour (started after four hours) [Figure 4] with intravenous patient-controlled analgesia (IV-PCA) of 10 mcg/bolus of fentanyl with lock-out interval of 10 minutes.