Ultrasonography-guided rectus sheath block in paediatric anaesthesia—a new approach to an old technique

Abstract

The bilateral placement of levobupivacaine 0.25% 0.1 ml kg(-1) in the space between the posterior aspect of the rectus sheath and the rectus abdominis muscle under real-time ultrasonographic guidance provides sufficient analgesia for umbilical hernia repair. The unpredictable depth of the posterior rectus sheath in children is a good argument for the use of ultrasonography in this regional anaesthetic technique in children.

Comparison of 0.25% Ropivacaine for Intraperitoneal Instillation v/s Rectus Sheath Block for Postoperative Pain Relief Following Laparoscopic Cholecystectomy: A Prospective Study

“…RSB has been used to achieve post operative analgesia in a variety of clinical settings including umbilical hernia repair [6,7,19], abdominoplasty [20], following laparoscopy [21,22], upper abdominal [23] and major gynaecological surgery [24]. There are wide discrepancies in the results from various studies due to different age group of the patients studied, operator expertise, extent and nature of surgery and technique of RSB.…”

“…Intraperitoneal local anaesthetic administration [1] and rectus sheath block (RSB) [6,7] have been used as a method for reducing postoperative pain. Intraperitoneal local anaesthetics acts on visceral nociceptors of peritoneum [8] whereas rectus sheath block, with successful blockade of intercostal nerves, provides full thickness anaesthesia of anterior abdominal wall [9].…”

“…Intraperitoneal local anaesthetics acts on visceral nociceptors of peritoneum [8] whereas rectus sheath block, with successful blockade of intercostal nerves, provides full thickness anaesthesia of anterior abdominal wall [9]. Previously individual studies have been conducted to evaluate the efficacy of intraperitoneal instillation [1] of local anaesthetics and RSB [6,7], however, we have not come across any studies comparing the efficacy of intraperitoneal instillation versus RSB to evaluate the superiority of one over another for postoperative pain relief after LC.…”

Continuous local anesthetic infusion through ultrasound-guided rectus sheath catheters

“…This ultrasound-guided technique has recently gained popularity owing to fewer complications and a higher success rate. [2][3][4] Since the duration of the RS block is limited by single injection, it is necessary to develop longer lasting analgesic methods for smooth postoperative recovery. A few attempts using RS catheters have been reported, including continuous administration of a large volume (42 mLÁhr -1 ) of local anesthetic.…”

Bilateral rectus sheath blocks as the single anaesthetic technique for an open infraumbilical hernia repair

“…(3) In recent times, rectus sheath block is more commonly used in paediatric patients. (4,5) Its use in abdominal gynaecological procedures and umbilical hernia repair has also been described. (6)(7)(8) In two previously reported cases, it was the sole anaesthetic used for elective umbilical surgery in high-risk patients with poor cardiovascular and physiological reserves.…”