Fascial plane blocks: moving from the expansionist to the reductionist era

Patient safety, improved quality of care, and better patient satisfaction and functional outcomes are currently the topmost priorities in regional anaesthesia (RA) and all advancements in RA move in this direction. Ultrasonography-guided central neuraxial and peripheral nerve blocks, intracluster and intratruncal injections, fascial plane blocks, diaphragm-sparing blocks, use of continuous nerve block techniques, and continuous local anaesthetic wound infiltration catheters are now topics of popular clinical interest. The safety and efficacy of nerve blocks can be improved with the help of injection pressure monitoring and the incorporation of advanced technology in the ultrasound machine and needles. Novel procedure-specific and motor-sparing nerve blocks have come up. The anaesthesiologist of the current era, with a good understanding of the sonoanatomy of the target area and the microarchitecture of nerves, along with the backup of advanced technology, can be very successful in performing RA techniques. RA is rapidly evolving and revolutionising the practice of anaesthesia.

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“…[ 19 ] Posterior transversus abdominis plane (TAP) block and lateral QLB combination can be used for lower abdominal surgery. [ 20 ]…”

Section: Advances In Regional Anaesthesia Techniques and Technologymentioning

confidence: 99%

Recent advancements in regional anaesthesia

Kurdi

Thakkar

Arora

et al. 2023

Indian Journal of Anaesthesia

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“…1 EOIB, because of the extensive attachments of the EOM and by virtue of being a fascial plane block, the drug spread covers an extensive anatomical area. 2 Although EOM is predominately an abdominal muscle, a large part of it lies over the thoracic cage. It originates from the external surface of the lower eight ribs T5-T12 and inserts into the linea alba, iliac crest, and pubic tubercle.…”

Section: Introductionmentioning

confidence: 99%

External oblique intercostal block in open nephrectomy patients - A zenith in analgesia for anterolateral upper abdominal surgeries: A case series

Priyanka Bansal,

Nidhi Sultania,

Tarun Mittal

2024

Asian J Med Sci

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Open nephrectomy is a common surgery usually performed for malignant and non-malignant renal pathologies. The external oblique intercostal block (EOIB) blocks the anterior and lateral cutaneous nerves from T6 to T10 and provides somatic analgesia. We present a case series of the use of EOIB in patients undergoing open nephrectomy by subcostal incision. Ten patients were given EOIB, which included patients undergoing simple nephrectomy for non-functioning kidneys and radical nephrectomy for renal mass. The patients had satisfactory numerical rating scale scores, mostly <4 for 24 h. Post-operative opioid consumption was minimal. The external oblique fascial plain block is a novel thoracic block that provides reliable upper thoracoabdominal somatic analgesia. It can certainly be considered a suitable option in surgeries such as nephrectomies that involve an upper lateral abdominal wall incision.

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