Determination of spread of injectate after ultrasound-guided transversus abdominis plane block: a cadaveric study.
نویسندگان
چکیده
BACKGROUND The transversus abdominis plane (TAP) block is a new regional anaesthesia technique that provides analgesia after abdominal surgery. It involves injection of local anaesthetic into the plane between the transversus abdominis and the internal oblique muscles. The TAP block can be performed using a landmark technique through the lumbar triangle or with ultrasound guidance. The goal of this anatomical study with dye injection into the TAP and subsequent cadaver dissections was to establish the likely spread of local anaesthesia in vivo and the segmental nerve involvement resulting from ultrasound-guided TAP block. METHODS An ultrasound-guided injection of aniline dye into the TAP was performed for each hemi-abdominal wall of 10 unembalmed human cadavers and this was followed by dissection to determine the extent of dye spread and nerve involvement in the dye injection. RESULTS After excluding one pilot specimen and one with advanced tissue decomposition, 16 hemi-abdominal walls were successfully injected and dissected. The lower thoracic nerves (T10-T12) and first lumbar nerve (L1) were found emerging from posterior to anterior between the costal margin and the iliac crest. Segmental nerves T10, T11, T12, and L1 were involved in the dye in 50%, 100%, 100%, and 93% of cases, respectively. CONCLUSIONS This anatomical study shows that an ultrasound-guided TAP injection cephalad to the iliac crest is likely to involve the T10-L1 nerve roots, and implies that the technique may be limited to use in lower abdominal surgery.
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Journal of Anaesthesiology Clinical Pharmacology | Volume 33 | Issue 1 | January-March 2017 133 transversus abdominis plane (TAP) block. Anaesth Intensive Care 2007;35:616‐7. 4. Tran TM, Ivanusic JJ, Hebbard P, Barrington MJ. Determination of spread of injectate after ultrasound‐guided transversus abdominis plane block: A cadaveric study. Br J Anaesth 2009;102:123‐7. 5. Rozen WM, Tran TM, Ashto...
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763–7 2 Hebbard P. Subcostal transversus abdominis plane block under ultrasound guidance. Anesth Analg 2008; 106: 674–5 3 Hebbard P, Fujiwara Y, Shibata Y, Royse C. Ultrasound-guided transversus abdominis plane (TAP) block. Anaesth Intensive Care 2007; 35: 616–7 4 Tran TMN, Ivanusic JJ, Hebbard P, et al. Determination of spread of injectate after ultrasound-guided transversus abdominis plane bl...
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BACKGROUND Ultrasound-guided transversus abdominis plane (TAP) injections are increasingly being used as an alternative to traditional perioperative analgesia in the abdominal region. With the use of a "blind" TAP block technique, these procedures have had variable success in cadaver and in vivo studies. For more accurate injection with the intended medication, ultrasound guidance allows visual...
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ورودعنوان ژورنال:
- British journal of anaesthesia
دوره 102 1 شماره
صفحات -
تاریخ انتشار 2009