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Case Reports
. 2021 Feb;49(1):63-66.
doi: 10.5152/TJAR.2020.156. Epub 2020 Dec 24.

Ultrasonography-Guided Oblique Subcostal Transversus Abdominis Plane Block in Combination with Ultrasonography-Guided Rectus Sheath Block for Anaesthesia in Abdominal Wall Surgery

Hande Gürbüz  1
Affiliations
Case Reports

Ultrasonography-Guided Oblique Subcostal Transversus Abdominis Plane Block in Combination with Ultrasonography-Guided Rectus Sheath Block for Anaesthesia in Abdominal Wall Surgery

Hande Gürbüz. Turk J Anaesthesiol Reanim. 2021 Feb.

Abstract

Abdominal wall blocks provide considerable analgesia for relieving post-operative pain. Although they have been performed generally for post-operative pain management, abdominal wall blocks can be used as the principal anaesthesia method in certain cases. In this study, the case of a 47-year-old male patient who underwent surgical excisional biopsy for 2 vague intramuscular mass lesions (was within the rectus abdominis muscle and the other was within the transversus abdominis muscle) was presented. Ultrasonography (USG)-guided oblique subcostal transversus abdominis plane block in combination with USG-guided rectus sheath block was performed successfully as anaesthesia for the abdominal wall surgery. The intervention was performed fully under regional anaesthesia without any need for deep sedation or general anaesthesia.

Keywords: Abdominal wall; oblique subcostal transversus abdominis plane block; pain management; rectus sheath block; regional anaesthesia.

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Conflict of interest statement

Conflict of Interest: The author have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Sonogram of the anterior abdominal wall (arrows indicating the mass lesion within the rectus abdominis muscle)
Figure 2
Figure 2
Sonogram of the rectus sheath block Left: Labelled sonogram showing the advancing needle; Right: Hydrodissection of the posterior aspect of the rectus abdominis muscle from posterior rectus sheath
Figure 3
Figure 3
Diagram showing the scan positions for the blocks U: Umbilicus; X: Xiphoid process; P1: Probe position for rectus sheath block; P2: Probe position for oblique subcostal transversus abdominis plane block; M1: Location of the first mass lesion within the rectus abdominis muscle; M2: Location of the second mass lesion within the transversus abdominis muscle
See this image and copyright information in PMC

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