Ultrasound-guided continuous oblique subcostal transversus abdominis plane blockade: description of anatomy and clinical technique.
نویسندگان
چکیده
BACKGROUND Recently, ultrasound-guided transversus abdominis plane blockade for abdominal wall analgesia has been described, and it involves injection of local anesthetic into the transversus abdominis plane. The posterior approach involves injection of local anesthetic in the lateral abdominal wall between the costal margin and the iliac crest and is suitable for postoperative analgesia after surgery below the umbilicus. The subcostal approach is suitable after abdominal surgery in the periumbilical region. The subcostal block can be modified, and the needle can be introduced along the oblique subcostal line from the xyphoid process toward the anterior part of the iliac crest. OBJECTIVE The purpose of this brief technical report was to describe in detail the anatomy and the technique of continuous oblique subcostal blockade. The goal of this approach was to produce a wider sensory blockade suitable for analgesia after surgery both superior and inferior to the umbilicus. CONCLUSIONS A catheter can be placed along the oblique subcostal line in the transversus abdominis plane for continuous infusion of local anesthetic. Multimodal analgesia and intravenous opioid are used in addition because visceral pain is not blocked. Continuous oblique subcostal transversus abdominis plane block is a new technique and requires both a detailed knowledge of sonographic anatomy and technical skill for it to be successful.
منابع مشابه
Effective dermatomal blockade after subcostal transversus abdominis plane block.
INTRODUCTION The ultrasound-guided transversus abdominis plane (TAP) block is used to treat postoperative pain after abdominal surgery. Abdominal wall sensory nerves are anaesthetised by injecting local anaesthetics into the neurofascial plane between the internal oblique and the transversus abdominis muscles. Sensory assessment of a TAP block may guide the decision on the extent of the block. ...
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BACKGROUND To observe intraoperative and postoperative analgesic effect of ultrasound-guided subcostal transversus abdominis plane (TAP) block in gastric cancer patients undergoing open gastrectomy. MATERIAL AND METHODS Forty patients with gastric cancer underwent open gastrectomy were randomly assigned into groups R and S. All patients received ultrasound-guided subcostal bilateral TAP under...
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BACKGROUND AND GOAL OF STUDY After laparoscopic cholecystectomy, patients have moderate pain in the early postoperative period. Some studies shown beneficial effects of subcostal transversus abdominis plane block on reducing this pain. Our goal was to investigate influence of subcostal transversus abdominis plane block on postoperative pain scores and opioid consumption. MATERIALS AND METHODS...
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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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عنوان ژورنال:
- Regional anesthesia and pain medicine
دوره 35 5 شماره
صفحات -
تاریخ انتشار 2010