Essentials of Our Current Understanding: Abdominal Wall Blocks.

Published

Journal Article (Review)

Abdominal wall blocks rely on the spread of local anesthetic within musculofascial planes to anesthetize multiple small nerves or plexuses, rather than targeting specific nerve structures. Ultrasonography is primarily responsible for the widespread adoption of techniques including transversus abdominis plane and rectus sheath blocks, as well as the introduction of novel techniques such as quadratus lumborum and transversalis fascia blocks. These blocks are technically straightforward and relatively safe and reduce pain and opioid requirements in many clinical settings. The data supporting these outcomes, however, can be inconsistent because of heterogeneity of study design. The extent of sensory blockade is also somewhat variable, because it depends on the achieved spread of local anesthetic and the anatomical course of the nerves being targeted. The blocks mainly provide somatic analgesia and are best used as part of a multimodal analgesic regimen. This review summarizes the anatomical, sonographic, and technical aspects of the abdominal wall blocks in current use, examining the current evidence for the efficacy and safety of each.

Full Text

Duke Authors

Cited Authors

  • Chin, KJ; McDonnell, JG; Carvalho, B; Sharkey, A; Pawa, A; Gadsden, J

Published In

Volume / Issue

  • 42 / 2

Start / End Page

  • 133 - 183

PubMed ID

  • 28085788

Pubmed Central ID

  • 28085788

Electronic International Standard Serial Number (EISSN)

  • 1532-8651

Digital Object Identifier (DOI)

  • 10.1097/AAP.0000000000000545

Language

  • eng

Conference Location

  • England