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Determination of spread of injectate after ultrasound-guided transversus abdominis plane block: a cadaveric study.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Tran, T. M. N. Ivanusic, Jason J. Hebbard, Peter D. Barrington, Michael J. |
| Copyright Year | 2009 |
| Abstract | 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. |
| File Format | PDF HTM / HTML |
| DOI | 10.1093/bja/aen344 |
| PubMed reference number | 19059922 |
| Journal | Medline |
| Volume Number | 102 |
| Issue Number | 1 |
| Alternate Webpage(s) | https://watermark.silverchair.com/aen344.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAZswggGXBgkqhkiG9w0BBwagggGIMIIBhAIBADCCAX0GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMYbsVVH9YowG7D9NBAgEQgIIBTjL4m-wuHw-y1345pNdmfFLMSEp6lBvNeXbLydvnhTZw5LLG8-lWV8w8Wzpn_WbidEpTrCGjVK0GLSNWzSGepJPA-YpqPITLCtxrXX2UaBGEQQxT73ukrcT5chHb0LUoWNZHiP1IUfBMk11jmkCMtIyZLDBnJOMekOJLTiJFtId4LIp9ojUhrNC2UwyWFqtwVIcZ29yigS0kqahdBZ-HPYEQmGlmMG5oatxT8Vg1HhKRbGFUqZhVD3T1Jx-auBJ1Zrtlph0-o4A9BJEGejKxAvL64ewXZdMTxAutsMGcfVccRkZS1xhl2znJuE1pnX8zstR6vmOJQ1pRq0ykBSJrjP-IZaKErrPv3qtquT-ezb9q5J8Yfay9gNVtk92HUM59hWCd1Gj3W2lUoMk3-RaXFVWQ3RcFCKxuP07V_0L9ta-DE7e_1hNthejtFh9yta8 |
| Alternate Webpage(s) | https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/bja/102/1/10.1093/bja/aen344/2/aen344.pdf?Expires=1492646644&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q&Signature=DVU9sV7KzMy4dkMlKehAph7FLHut6aNSNDB8UDhiOgBT2QGqW0k-N1MJfrhQKRGbHPxpSw2yWjTKnjJLXLqNhY2tBfrdKmKUgqWv5HY5D2EV0hSZvSIHzmSw~I2gRh2yLGd8n-kBdXJGaJSlNfLESROPFwSjXzMR1nIG7ShPSHajCHdsaK12gfGJcO8~8a3Jz4zHz4wiu7Qhv87fd1ZBAIJQCsWnTMUrK7~rgPYXg-wCJCMLuXlW4AhcnDyBiRIfrTn1qnMZ~nm~2ThWqhwEkHYcLbWcah5e6dy8cS2iojEBg2L3L0ch9-AAq3h7RlEA6rPtmcDds2lAHgNNGoS5DQ__ |
| Alternate Webpage(s) | https://doi.org/10.1093/bja%2Faen344 |
| Journal | British journal of anaesthesia |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
