The advantages of ultrasound guidance for RSB are similar to those for TAPB. A 100% success rate has been reported in the ability to visualize the spread of anesthetic between the RAM and the posterior sheath (Willschke 2006 (2)). In a study, the anesthetic was placed in the correct plane in only 45% of cases using a loss of resistance technique by trainees with no previous experience and in 89% of cases using ultrasound guidance (Dolan 2009). The difference became more pronounced as patient body mass index increased. 21% of injections performed using the loss of resistance technique were intraperitoneal and 35% too superficial. Ultrasound-guided RSB is carried out with the transducer placed in the longitudinal plane near the lateral edge of the rectus sheath (Figure 6.3). The distribution of the local anesthetic can be monitored under real-time imaging. The local anesthetic is injected between the RAM and the posterior sheath (Figure 6.1). Skin incision can be performed 15 minutes or later after placement of the block.
Rectus sheath block
SPADARO, Savino;
2011
Abstract
The advantages of ultrasound guidance for RSB are similar to those for TAPB. A 100% success rate has been reported in the ability to visualize the spread of anesthetic between the RAM and the posterior sheath (Willschke 2006 (2)). In a study, the anesthetic was placed in the correct plane in only 45% of cases using a loss of resistance technique by trainees with no previous experience and in 89% of cases using ultrasound guidance (Dolan 2009). The difference became more pronounced as patient body mass index increased. 21% of injections performed using the loss of resistance technique were intraperitoneal and 35% too superficial. Ultrasound-guided RSB is carried out with the transducer placed in the longitudinal plane near the lateral edge of the rectus sheath (Figure 6.3). The distribution of the local anesthetic can be monitored under real-time imaging. The local anesthetic is injected between the RAM and the posterior sheath (Figure 6.1). Skin incision can be performed 15 minutes or later after placement of the block.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
