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Abdominal Wall Blocks in Abdominal Surgery: An Update

Vol 2 | Issue 1 | January-June 2021 | Page 47-53 | TVS Gopal, Amjad Maniar, Arunangshu Chakraborty,
Rammurthy Kulkarni


Authors:  TVS Gopal [1], Amjad Maniar [2], Arunangshu Chakraborty [3], Rammurthy Kulkarni [2]

[1] Department of Anaesthesia, Care Hospitals, Banjara Hills, Hyderabad, Andhra Pradesh, India.
[2] Department of Anaesthesia, Axon Anaesthesia Associates, Bengaluru, India.
[3] Department of Anaesthesia, Tata Medical Center, Kolkata, India.

Address of Correspondence
Dr. TVS Gopal,
Clinical Director, Care Hospitals, Banjara Hills, Hyderabad, Andhra Pradesh, India.
E-mail: tvsgopal@gmail.com


Abstract


Abdominal wall blocks provide an alternative to the gold standard, epidural analgesia, as a part of a multimodal analgesic regime for pain relief following a variety of abdominal surgeries. The ubiquitous availability of ultrasound and the paradigm shift to deposition of local anaesthetic into interfascial planes popularized abdominal wall blocks. Over the years, a better understanding of cadaveric, clinical sonoanatomy, and techniques have emerged. However, with certain abdominal wall blocks, the spread of local anaesthetic is neither consistent nor predictable. This concise update presents details pertaining to ultrasound-guided abdominal wall blocks.


References


1. Susan M Nimmo, Lorraine S Harrington. What is the role of epidural analgesia in abdominal surgery ? Continuing Education in Anaesthesia, Critical care and Pain 2014; Vol.14.
2. Schliech D. Schmerzlose Operationen. In Springer Verlag; 1899.p.240-58 (4th edition)
3. Thomas H Seldon. Regional anesthesia for surgery of the thorax and abdominal wall. Section on Anesthesia 1941, Mayo Clinic, Rochester, Minnesota; Vol.2.
4. Rafi AN. Abdominal field block ; a new approach via the lumbar triangle. Anaesthesia 2001; 56(10) : 1024-6.
5. Mc Donnell JG, O’Donnell BD, Farrell T et al. Transversus abdominis plane block ; a cadaver and radiological evaluation. Reg Anesth Pain med.2001; 32 ;399-404.
6. Hebbard P, Fujiwara Y, Shibata Y, Royse C. ultrasound-guided transversus abdominis plane (TAP) block. Anaesth Intensive care 2007 Aug; 35(4) : 616-7.
7. Ki Jinn Chin, John G McDonnell, Brendan Carvalho et al. essentials of our current understanding : abdominal wall blocks. Reg Anesth Pain Med 2017; 42 : 133-183.
8. DN Onwochei, J Borglum, A Pawa. Abdominal wall blocks for intra-abdominal surgery. BJA Education 2018; Vol.18, No.10.
9. FH Willard, A Vleeming, MD Schuenke et al. the thoracolumbar fascia : anatomy, function and clinical considerations. Journal of Anatomy 2012; 221(6) : 507-536.
10. Ferguson S, Thomas V, Lewis I. the rectus sheath block in pediatric anaesthesia : new indications for an old technique ? Pediatric Anesthesia 1996 Dec; 6(6) : 463-6.
11. Melesse DY, Chekol WB, Tawuye HY, Denu ZA et al. Assessment of the analgesic effectiveness of rectus sheath block in patients who had an emergency midline laparotomy : prospective observational cohort study. International Journal of Surgery open 2020; 24 :27-31.
12. Lee THW, Barrington MJ, Tran TNM, Wong D, Hebbard P. Comparison of extent of sensory block following posterior and subcostal approaches to ultrasound-guided transversus abdominis plane block. Anaesthesia and Intensive care 2010 May; 38(3): 452-460.
13. Yoshiyoma S, Ueshima H, Sakai R, Otake H. A posterior TAP block provides more effective analgesia than a lateral TAP block in patients undergoing laparoscopic gynaecologic surgery : a retrospective study. Anesthesiology Research and Practice 2016; 2016 :1-5.
14. Hebbard P. Subcostal transversus abdominis plane block under ultrasound guidance. Anesthesia and Analgesia 2008; 106(2).
15. Klaassen Z, Marshall E, Tubbs RS, Louis RGJ et al. Anatomy of the ilioinguinal and iliohypogastric nerves with observations of their spinal nerve contributions. Clin Anat. 2011 May; 24(4) : 454-61.
16. Hebbard P. Transversalis fascia plane block, a novel ultrasound guided abdominal wall nerve block. Can J Anesth. 2009 Aug; 56(8) :618-20.
17. Hesham Elsharkawy, Kariem El-Boghdadly, Michael Barrington. Quadratus lumborum block : anatomical concepts, mechanisms and techniques. Anesthesiology Feb 2019; Vol.130, No.2.
18. Sauter AR, Ullensvang K, Niemi G, Lorentzen HT, Bensten TF, Borglum J. The shamrock lumbar plexus block : a dose finding study. Eur J Anaesthesiol 2015; 32 : 764-70.
19. Murouchi T. Quadratus lumborum block intramuscular approach for pediatric surgery. Acta Anesthesiologica Taiwanica 2016.
20. TVS Gopal. Ultrasound guided transmuscular quadratus lumborum plane catheters : in the plane or out of it ? Editorial- Indian J Anaesth 2019; 63 :609-10.
21. Diwan S, Kulkarni M, Kulkarni N, Nair A. A radiological inquest to determine the destiny of ultrasound guided transmuscular quadratus lumborum plane catheters. Indian J Anaesth 2019; 63 : 667-70.
22. Lancaster P, Chadwick M. Liver trauma secondary to ultrasound-guided transversus abdominis plane block. Br J Anaesth. 2010 Apr;104(4):509–10.
23. Farooq M, Carey M. A case of liver trauma with a blunt regional anesthesia needle while performing transversus abdominis plane block. Reg Anesth Pain Med. 2008 Jun;33(3):274–5.
24. Frigon C, Mai R, Valois-Gomez T, Desparmet J. Bowel hematoma following an iliohypogastric-ilioinguinal nerve block. Paediatr Anaesth. 2006 Sep;16(9):993–6.
25. Yuen PM, Ng PS. Retroperitoneal hematoma after a rectus sheath block. J Am Assoc Gynecol Laparosc. 2004 Nov;11(4):448.
26. Griffiths JD, Barron FA, Grant S, Bjorksten AR, Hebbard P, Royse CF. Plasma ropivacaine concentrations after ultrasound-guided transversus abdominis plane block. Br J Anaesth. 2010 Dec;105(6):853–6.
27. Hessian EC, Evans BE, Woods JA, Taylor DJ, Kinkel E, Bjorksten AR. Plasma ropivacaine concentrations during bilateral transversus abdominis plane infusions. British Journal of Anaesthesia. 2013 Sep 1;111(3):488–95.
28. Shivashanmugam T, Kundra P, Sudhakar S. Iliac compartment block following ilioinguinal iliohypogastric nerve block. Paediatr Anaesth. 2006 Oct;16(10):1084–6.
29. Ghani KR, McMillan R, Paterson-Brown S. Transient femoral nerve palsy following ilio-inguinal nerve blockade for day case inguinal hernia repair. J R Coll Surg Edinb. 2002 Aug;47(4):626–9.
30. Manatakis DK, Stamos N, Agalianos C, Karvelis MA, Gkiaourakis M, Davides D. Transient femoral nerve palsy complicating “blind” transversus abdominis plane block. Case reports in anesthesiology. 2013;2013:874215.
31. Quek KHY, Phua DSK. Bilateral rectus sheath blocks as the single anaesthetic technique for an open infraumbilical hernia repair. Singapore Med J. 2014 Mar;55(3):e39-41.
32. Rajwani KM, Butler S, Mahomed A. In children undergoing umbilical hernia repair is rectus sheath block effective at reducing post-operative pain? Best evidence topic (bet). International Journal of Surgery. 2014;12(12):1452–5.
33. Tudor ECG, Yang W, Brown R, Mackey PM. Rectus sheath catheters provide equivalent analgesia to epidurals following laparotomy for colorectal surgery. Ann R Coll Surg Engl. 2015 Oct;97(7):530–3.
34. Godden AR, Marshall MJ, Grice AS, Daniels IR. Ultrasonography guided rectus sheath catheters versus epidural analgesia for open colorectal cancer surgery in a single centre. Ann R Coll Surg Engl. 2013 Nov;95(8):591–4.
35. Baeriswyl M, Kirkham KR, Kern C, Albrecht E. The Analgesic Efficacy of Ultrasound-Guided Transversus Abdominis Plane Block in Adult Patients: A Meta-Analysis. Anesthesia & Analgesia. 2015 Dec;121(6):1640–54.
36. De Oliveira GS, Castro-Alves LJ, Nader A, Kendall MC, McCarthy RJ. Transversus Abdominis Plane Block to Ameliorate Postoperative Pain Outcomes After Laparoscopic Surgery: A Meta-Analysis of Randomized Controlled Trials. Anesthesia & Analgesia. 2014 Feb;118(2):454–63.
37. Mishriky BM, George RB, Habib AS. Transversus abdominis plane block for analgesia after Cesarean delivery: a systematic review and meta-analysis. Can J Anesth/J Can Anesth. 2012 Aug;59(8):766–78.
38. Hannallah RS, Broadman LM, Belman AB, Abramowitz MD, Epstein BS. Comparison of caudal and ilioinguinal/iliohypogastric nerve blocks for control of post-orchiopexy pain in pediatric ambulatory surgery. Anesthesiology. 1987 Jun;66(6):832–4.
39. Markham SJ, Tomlinson J, Hain WR. Ilioinguinal nerve block in children. A comparison with caudal block for intra and postoperative analgesia. Anaesthesia. 1986 Nov;41(11):1098–103.
40. Reid MF, Harris R, Phillips PD, Barker I, Pereira NH, Bennett NR. Day-case herniotomy in children. A comparison of ilio-inguinal nerve block and wound infiltration for postoperative analgesia. Anaesthesia. 1987 Jun;42(6):658–61.
41. Blanco R, Ansari T, Girgis E. Quadratus lumborum block for postoperative pain after caesarean section: A randomised controlled trial. Eur J Anaesthesiol. 2015 Nov;32(11):812–8.
42. Mieszkowski MM, Mayzner-Zawadzka E, Tuyakov B, Mieszkowska M, Żukowski M, Waśniewski T, et al. Evaluation of the effectiveness of the Quadratus Lumborum Block type I using ropivacaine in postoperative analgesia after a cesarean section – a controlled clinical study. Ginekol Pol. 2018;89(2):89–96.
43. Ishio J, Komasawa N, Kido H, Minami T. Evaluation of ultrasound-guided posterior quadratus lumborum block for postoperative analgesia after laparoscopic gynecologic surgery. J Clin Anesth. 2017 Sep;41:1–4.
44. Öksüz G, Bilal B, Gürkan Y, Urfalioğlu A, Arslan M, Gişi G, et al. Quadratus Lumborum Block Versus Transversus Abdominis Plane Block in Children Undergoing Low Abdominal Surgery: <em>A Randomized Controlled Trial</em>. Reg Anesth Pain Med. 2017 Sep 1;42(5):674..
45. Aditianingsih D, Pryambodho, Anasy N, Tantri AR, Mochtar CA. A randomized controlled trial on analgesic effect of repeated Quadratus Lumborum block versus continuous epidural analgesia following laparoscopic nephrectomy. BMC Anesthesiology. 2019 Dec 5;19(1):221.


How to Cite this Article: Gopal TVS, Maniar A, Chakraborty A, Kulkarni R | Abdominal Wall
Blocks in Abdominal Surgery: An Update | International Journal of Regional Anaesthesia | January-June 2021; 2(1): 47-53.

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