Allgemeine Grundlagen der Sonographie, Teil 2

Seibel, Armin; Ca, Greim

doi:10.1007/s00101-015-0101-z

Cited by 3 publications

(1 citation statement)

References 4 publications

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“…The patient’s body weight should be taken into account when planning a postoperative TAP block. The depth and the frequency of the transducer may need to be adjusted and more time may need to be allocated for the procedure [21, 22]. Additionally, the choice of needle length may need to be optimized in this way too.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound anatomy of the transversus abdominis plane region in pregnant women before and after cesarean delivery

et al. 2016

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BackgroundAfter cesarean delivery, analgesia is often incomplete and a multimodal approach to analgesia is necessary. Transverse abdominal plane (TAP) block has been advocated in this setting, yet no systematic description of the ultrasound anatomy in pregnant women exists in the literature. Therefore, we aimed to describe the sonographical features of relevant structures in pregnant women before and after elective cesarean.MethodsSixty women at, or close to term scheduled for elective cesarean delivery underwent a standardized ultrasound examination before and after delivery. We assessed the visibility of the muscular layers and measured the distance from the skin to the layers of the abdominal wall muscles in the region for TAP block before and after cesarean section on both side.ResultsThe three muscular layers of the lateral abdominal wall (external oblique, internal oblique and transversus abdominis muscle) were visible in all examinations. Before cesarean section the median TAP distance was shorter: 2.9 cm (interquartile range 2.6–3.6) compared to 3.9 cm (3.1–4.5) after cesarean section (left side, p < 0.001). The external and internal oblique muscles were located closer to the skin surface before cesarean section. An increased body mass is associated with increased the TAP distance before and after birth (p < 0.001).ConclusionRelevant anatomical landmarks for a TAP block are sonographically well visible after cesarean delivery. Postoperatively, depth of the TAP as compared to before birth is increased significantly. Scanning the abdominal wall before CD will underestimate the target depth of the TAP after delivery. The obstetric anesthetist needs to be aware of these changes when planning a TAP block in the context of cesarean delivery.

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Section: Discussionmentioning

confidence: 99%

Ultrasound anatomy of the transversus abdominis plane region in pregnant women before and after cesarean delivery

et al. 2016

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Rund um mein Ultraschallgerät — was muss ich beachten?

Enzmann

Engelmann

2016

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Evaluation of Ultrasonographic Anatomy of Transversus Abdominis Plane before and after Cesarean Section

Özdemir¹

2022

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Transversus abdominis plane (TAP) block is used to provide analgesia after lower abdominal surgery operations. TAP block has been shown to reduce postoperative pain scores and side effects of opioids after cesarean section. Generally, TAP block was introduced after cesarean section. It is assumed that delivery affects sonographic characteristics of the abdominal wall. For this reason, ultrasonographic measurement of the anatomy of the region defined for TAP block was performed before and after cesarean section. It was aimed to determine the estimated TAP block distance in the population undergoing cesarean section. Fifty patients who underwent cesarean section in the operating room were included in the study. The inclusion criteria were ASA score I-II, age 18-45 years, gestational age ≥32 weeks, and cesarean section performed by Pfannenstiel incision. Data on patient age, weight, height, body mass index, gravidity, parity, gestational age (weeks), concomitant disease and allergy were recorded. According to the results obtained in the study, ultrasound should be performed if TAP block is accessible. Before cesarean section, the external oblique muscle and internal oblique muscle are closer to surface than after cesarean section since the TAP distance after pregnancy will be deeper. Systematic data on ultrasonographic anatomy of the abdominal wall in pregnant women have not yet been published. The obstetric anesthesiologist should be aware of these changes when planning a TAP block in the context of cesarean section. There is a need for larger prospective studies.

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Allgemeine Grundlagen der Sonographie, Teil 2

Cited by 3 publications

References 4 publications

Ultrasound anatomy of the transversus abdominis plane region in pregnant women before and after cesarean delivery

Ultrasound anatomy of the transversus abdominis plane region in pregnant women before and after cesarean delivery

Rund um mein Ultraschallgerät — was muss ich beachten?

Evaluation of Ultrasonographic Anatomy of Transversus Abdominis Plane before and after Cesarean Section

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