Transient abdominal motor block after a transversus abdominis plane block in an elderly patient

Bortolato, Andrea; Ori, Carlo; Freo, Ulderico

doi:10.1007/s12630-015-0341-z

Cited by 8 publications

(4 citation statements)

References 6 publications

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“…In turn, this could result in paresis of the abdominal muscles as evidenced by a bulge in the abdominal wall when the patient coughs or bears down. 229,230 In both reported cases, the bulge subsided uneventfully as the transversus abdominis plane block wore off. 229,230 In summary, based on the current knowledge, care must be taken to visualize the entire length of the needle during the performance of transversus abdominis plane blocks to prevent breaching the transversus abdominis muscle and the…”

Section: Complications Of Transversus Abdominis Plane Blocksmentioning

confidence: 87%

Transversus Abdominis Plane Block

et al. 2019

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In this narrative review article, the authors discuss the anatomy, nomenclature, history, approaches (posterior vs. lateral vs. subcostal), techniques, pharmacology, indications, and complications of transversus abdominis plane blocks, as well as possible alternative truncal blocks. Despite the scarcity of evidence and contradictory findings, certain clinical suggestions can nonetheless be made. Overall transversus abdominis plane blocks appear most beneficial in the setting of open appendectomy (posterior or lateral approach). Lateral transversus abdominis plane blocks are not suggested for laparoscopic hysterectomy, laparoscopic appendectomy, or open prostatectomy. However, transversus abdominis plane blocks could serve as an analgesic option for Cesarean delivery (posterior or lateral approach) and open colorectal section (subcostal or lateral approach) if there exist contraindications to intrathecal morphine and thoracic epidural analgesia, respectively. Future investigation is required to compare posterior and subcostal transversus abdominis plane blocks in clinical settings. Furthermore, posterior transversus abdominis plane blocks should be investigated for surgical interventions in which their lateral counterparts have proven not to be beneficial (e.g., laparoscopic hysterectomy/appendectomy, open prostatectomy). More importantly, because posterior transversus abdominis plane blocks can purportedly provide sympathetic blockade and visceral analgesia, they should be compared with thoracic epidural analgesia for open colorectal surgery. Finally, transversus abdominis plane blocks should be compared with newer truncal blocks (e.g., erector spinae plane and quadratus lumborum blocks) with well-designed and adequately powered trials.

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Section: Complications Of Transversus Abdominis Plane Blocksmentioning

confidence: 87%

Transversus Abdominis Plane Block

et al. 2019

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“…A recent meta-analysis investigating RSB-associated complications in >600 patients observed that no adverse event had been reported in relevant trials. 29 An international consensus recently proposed real-time ultrasound-guided RSB as 1 of 7 plane A blocks for perioperative pain management. 11 However, there is a lack of consistency in the anatomical descriptions and incidence of complications of the blocks.…”

Section: Discussionmentioning

confidence: 99%

Complications and Technical Consideration of Ultrasound-Guided Rectus Sheath Blocks: A Retrospective Analysis of 4033 Patients

Kwon

Kim

et al. 2022

Anesthesia &Amp; Analgesia

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BACKGROUND: Although the ultrasound-guided rectus sheath block (RSB) is usually regarded as an easy and safe procedure in clinical settings, there is currently no report on complications incidence. Therefore, the present study investigated complications in a large cohort and described the technical considerations to minimize complications of real-time ultrasound-guided RSBs. METHODS: This was a retrospective cohort study of patients who underwent real-time ultrasound-guided RSBs for perioperative pain control in laparoscopic surgery with an umbilical port between February 1, 2017, and February 28, 2021, at the Asan Medical Center in South Korea. All RSBs were performed bilaterally using a 23-gauge Quincke needle, and a bilateral 2-block placement was regarded as 1 RSB. Patient data, including demographics, preoperative laboratory data, preoperative antiplatelet or anticoagulant medication with the duration of discontinuation, and type of surgery, were collected to show the study population characteristics and explore potential factors associated with adverse events such as hematoma. Ultrasound images of patients and adverse events of RSBs, including extrarectus sheath injections, vascular injuries, bowel injury, or local anesthetic systemic toxicity, were also analyzed accordingly. RESULTS: A total of 4033 procedures were analyzed. The mean body mass index of the patients was 24.1 (21.8–26.5) kg/m2. The preoperative laboratory data were within normal range in 4028 (99.9%) patients. Preoperative antiplatelets or anticoagulants were administered in 17.3% of the patients. Overall, 96 complications (2.4%) were observed. Among them, extrarectus sheath injection occurred in 88 cases (2.2%), which included preperitoneal injection (0.9%) and intraperitoneal injection (1.3%). Vascular injuries constituted 8 cases (0.2%) and all vascular injuries resulted in hematoma: 7 cases of inferior epigastric artery injury with rectus sheath hematoma and 1 of inferior mesenteric artery injury with retroperitoneal hematoma. Bowel injury or local anesthetic systemic toxicity was not reported. CONCLUSIONS: In this study of RSBs performed on 4033 patients using a 23-gauge Quincke needle in patients with low body mass index, there were 8 cases (0.2%) of vascular injury, all of which accompanied hematoma.

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“…Освен това има описан и моторен блок на тораколумбалните нерви след ТАР-блок, което се изразява в пареза на коремните мускули и издуване на коремната стена, когато пациентът кашля или е отпуснат. И в двата случая симптомите са отминали спонтанно (8).…”

Section: контраиндикации и усложненияunclassified

Transversus abdominis plane block (TAP block)—part of the multimodal approach to analgesia in abdominal surgery. A review

Zanev,

Mladenov

2022

vmf

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РЕЗЮМЕБолката, получена след хирургична интервенция, продължава да бъде основно предизвикателство за медицината. Адекватна интраоперативна аналгезия при хирургия в коремната област може да се постигне с различни способи. Самостоятелното прилагане на който и да е от тях повишава риска от проява на странични ефекти поради необходимост от прекомерно висока доза на медикаментите или недостатъчност на метода като монотерапия. Съвременните препоръки са за използване на комбинация от аналгетични техники за постигането на оптимален ефект при минимални рискове. Цел на настоящия обзор е да обобщи значението на въвеждането в практиката на блока на трансверзалната коремна равнина, ТАР-блок (от англ. Transversus Abdominis Plane) за интраоперативното обезболяване при хирургични интервенции в коремен отдел. Това дава нови перспективи пред мултимодалната аналгезия.

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Transient abdominal motor block after a transversus abdominis plane block in an elderly patient

Cited by 8 publications

References 6 publications

Transversus Abdominis Plane Block

Transversus Abdominis Plane Block

Complications and Technical Consideration of Ultrasound-Guided Rectus Sheath Blocks: A Retrospective Analysis of 4033 Patients

Transversus abdominis plane block (TAP block)—part of the multimodal approach to analgesia in abdominal surgery. A review

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