Skin marking for ultrasound-guided thoracic paravertebral block

For both real time continuous and intermittent ultrasound guided block, draw two lines, one over the spinous processes and other over the lateral tips of the transverse processes. Count the ribs, and draw a medial-lateral line that marks the rib(s) and corresponding transverse processes for the desired block level. Mark the levels of the desired paravertebral spaces.