Ultraschallgestützte Regionalanästhesie in der Thoraxchirurgie

Abstract

Lokalisationen für RumpfwandblockadenWie in ▶ Abb. 2 ersichtlich, gibt es eine Vielzahl an Lokalisationen, an denen sog. Rumpfwandblockaden möglich sind. Während bei den peripheren Nervenblockaden die Ausbreitung des Lokalanästhetikums direkt am Nerv dargestellt werden kann, ist bei den Rumpfwandblockaden

Letter to the Editor

“…There is no evidence that the branches of intercostal nerves in the TAPB site carry significant motor and visceral fibers. This is clearly different from dorsal thoracic or abdominal wall blocks, such as the paravertebral, erector spinae plane, and retrolaminar blocks, in which the local anesthetic injected between the paraspinal muscles and the transverse process may spread caudally and cranially into the paravertebral space, affecting the ventral and dorsal branches of the spinal nerves and the rami communicants that contain sensory, motor, and visceral fibers 6 …”

“…This is clearly different from dorsal thoracic or abdominal wall blocks, such as the paravertebral, erector spinae plane, and retrolaminar blocks, in which the local anesthetic injected between the paraspinal muscles and the transverse process may spread caudally and cranially into the paravertebral space, affecting the ventral and dorsal branches of the spinal nerves and the rami communicants that contain sensory, motor, and visceral fibers. 6 Fang I would like to thank Professor Fu-Shan Xue and his colleagues for the thoughtful and thorough review of our article. The questions and concerns merit analysis and discussion; however, the profound effect (almost two-thirds reduction in Post Anesthetic Care Unit (PACU) opioid utilization and 18.5% decreased patient time in PACU) that occurred after the routine adoption of transversus abdominis plane (TAP) blocks in our surgery center was undeniable and was first noticed and reported by our PACU nursing staff.…”

Comparing analgesic efficacy of continuous serratus anterior plane and thoracic epidural blocks for multiple rib fractures

“…Finally, acute pain by the MRF includes sensory and visceral components. 4 It must be noted that the SAPB is an anterolateral thoracic wall block and is often used a component of the opioid-sparing multimodal anaesthesia strategy, as it does not include visceral blocks. 5 It may be one of the reasons that the SABP is inferior to epidural block in providing analgesia over the first 12 h following the block in this study.…”