2022 Volume 42 Issue 2 Pages 141-147
Aspirin-exacerbated respiratory disease（AERD）is a chronic inflammatory airway disorder, in which some kinds of drugs and food additives induce a severe asthma attack. Mid-point transverse process to pleura（MTP）block is a peripheral nerve block technique with a local anesthetic injection behind the superior costotransverse ligament around the transverse process and the head of the rib that induces a PVB-like effect.
We planned a medial upper limb tumor resection using regional anesthesia and sedation in an AERD patient with a history of severe asthma attacks during general anesthesia. Brachial plexus block alone provides insufficient analgesia for medial upper limb surgery, because the medial brachial side of the arm is innervated by both the medial brachial cutaneous nerve（the branch of the brachial plexus）and the intercostobrachial nerve（the branch of intercostal nerve）. We were able to provide excellent perioperative analgesia without an asthma attack by combining both blocks in the patient.
