Nerve Block Options for Pain Control during Hepatic and Upper Abdominal Minimally Invasive Procedures

Abstract

Availability of minimally invasive abdominal procedures can be restricted in cases of painful procedures, due to limited access to anesthesia support or the more recent avoidance of aerosol generating medical procedures such as intubation. Intravenous sedation, in many cases is insufficient to effectively control the pain, leaving patients to suffer undue discomfort and a medical team stressed by the situation. Regional nerve blocks can offer a solution but are underutilized, likely in large part due to a lack of knowledge of available options.This manuscript describes four different nerve blocks that can be useful for analgesia related to upper abdominal procedures. Available data are reviewed regarding their effectiveness and the technique used to perform them is described. Information provided aims to help decide which is likely to provide the best analgesia depending on the procedure being done. Increase use of these blocks has the potential to improve patient's accessibility to minimally invasive upper abdominal procedures.