<p>Interfascial Plane Blocks and Laparoscopic Abdominal Surgery: A Narrative Review</p>

Abstract

Laparoscopic abdominal surgery has become a mainstay of modern surgical practice. Postoperative analgesia is an integral component of recovery following laparoscopic abdominal surgery and may be improved by regional anesthesia or intravenous lidocaine infusion. There is inconsistent evidence supporting the use of interfascial plane blocks, such as transversus abdominis plane (TAP) blocks, for patients undergoing laparoscopic abdominal surgery as evidenced by variable patterns of local anesthetic spread and conflicting results from studies comparing TAP blocks to local anesthetic infiltration of laparoscopic port sites and multimodal analgesia. Quadratus lumborum (QL) and erector spinae plane (ESP) blocks may provide greater areas of somatic analgesia as well as visceral analgesia, which may translate to more significant clinical benefits. Aside from the locations of the surgical incisions, it is unclear what other factors should be considered when choosing one regional technique over another or deciding to infuse lidocaine intravenously. We reviewed the current literature in attempt to clarify the roles of various regional anesthesia techniques for patients undergoing laparoscopic abdominal surgery and present one possible approach to evaluating postoperative pain.

Quadratus lumborum blocks for abdominal transplant surgeries at UPMC Children's Hospital of Pittsburgh—A five year experience

“…QLBs have been part of our daily practice for over a decade, and many studies have shown their analgesic efficacy for different abdominal procedures. [16][17][18] However, concerns regarding coagulopathy and metabolism disturbances limit the application of QLBs in pediatric transplant surgeries. 11,12,16,19 Our study showed good postoperative pain control and decreased opioid consumption in the kidney transplant group and early extubation, short ICU and hospital stay, and a low complication rate.…”

“…Our study is the first pediatric retrospective study analyzing the use of QLBs for perioperative pain management after abdominal transplant surgery in children. QLBs have been part of our daily practice for over a decade, and many studies have shown their analgesic efficacy for different abdominal procedures 16–18 . However, concerns regarding coagulopathy and metabolism disturbances limit the application of QLBs in pediatric transplant surgeries 11,12,16,19 .…”

Role of regional anesthesia in Enhanced Recovery After Surgery (ERAS) protocols

“…Additionally, newer interventional modalities, such as QL and ESP blocks, have been proposed as good alternatives since they potentially provide somatic and visceral analgesia. However, current evidence has not shown clear benefits of using these techniques when compared to TAP blocks [75,76]. Further clarification is needed to determine the role of these techniques in abdominal surgery and ERAS protocols.…”

Thoracic Erector Spinae Plane (T-ESP) Block Together With Intertransverse Process (ITP) Block for Laparoscopic Abdominal Surgery: A Case Report

“…Laparoscopic abdominal surgery has become a mainstay of modern surgery with reduced surgical stress and postoperative pain. Evidence promotes thoracic erector spinae (T-ESP) block (T7-9) for laparoscopic abdominal surgery in particular from studies investigating pain following laparoscopic cholecystectomy (LC) [ 1 , 2 ]. The ESP block first described by Forero et al in 2016 [ 3 ] has been shown to be useful in many surgeries.…”