Document Detail


Laparoscopic-guided transversus abdominis plane block for colorectal surgery.
MedLine Citation:
PMID:  23392158     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
The transversus abdominis plane block has been used as a component of postoperative analgesia after hysterectomy and open abdominal surgery. This block involves the injection of anesthetic between the internal oblique and transversus abdominis muscles. We demonstrate an improved method by the use of laparoscopic guidance for transversus abdominis plane blocks.Transversus abdominis plane blocks are performed at the conclusion of an elective laparoscopic procedure by an experienced colorectal surgeon. With the use of direct visualization with a laparoscope, a Braun Stimuplex A insulated needle is passed through the skin at the level of the midaxillary line, midway between the iliac crest and the costal margin. The needle is inserted further until 2 distinct "pops" are felt, indicating the correct needle position between the internal oblique and transversus abdominis muscle. The laparoscope confirms a bulge, which signifies the injectate covered by the transversus abdominis muscle. The procedure is performed at a second injection site on the same side and bilaterally.The transversus abdominis plane block is useful as an adjunct to reduce postoperative analgesia in patients undergoing laparoscopic colorectal surgery. Our method for transversus abdominis plane blocks with the use of laparoscopy is easily performed at the conclusion of any laparoscopic procedure. Prospective randomized trials are necessary to assess the significance of these blocks in postoperative pain control, length of stay, and cost benefit.
Authors:
Joanne Favuzza; Conor P Delaney
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  56     ISSN:  1530-0358     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  389-91     Citation Subset:  IM    
Affiliation:
Department of Colorectal Surgery, University Hospitals Case Medical Center, Cleveland, Ohio.
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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