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Transversalis Block

Rakesh V Sondekoppam, Vivian Ip, David F Johnston, Vishal Uppal, Marjorie Johnson, Sugantha Ganapathy, Ban C H Tsui
BACKGROUND: The anterior iliac crest (AIC) is one of the most common sites for harvesting autologous bone, but the associated postoperative pain can result in significant morbidity. Recently, the transmuscular quadratus lumborum block (TQL) has been described to anesthetize the thoraco-lumbar nerves. This study utilizes a combination of cadaveric models and clinical case studies to evaluate the dermatomal coverage and analgesic utility of TQL for AIC bone graft donor site analgesia. METHODS: Ten ultrasound-guided TQL injections were performed in five cadaver specimens using a lateral-to-medial transmuscular approach...
November 21, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Paolo Scimia, Erika Basso Ricci, Emiliano Petrucci, Astrid Ursula Behr, Franco Marinangeli, Pierfrancesco Fusco
Ultrasound (US)-guided transversalis fascia plane block (TFPB) was first described by Hebbard as a technique for blockade of T12-L1 nerves. Although this technique appears similar to the quadratus lumborum 1 block, the point of injection is more caudal and anterior, specifically targeting ilioinguinal and iliohypogastric nerves. There are only few published data on US-guided TFPB demonstrating effective postoperative analgesia in iliac crest bone graft harvesting. We report the use of US-guided TFPB in a patient undergoing inguinal herniorrhaphy...
November 1, 2017: A & A Case Reports
Olivier Choquet, Xavier Capdevila
No abstract text is available yet for this article.
July 2017: Regional Anesthesia and Pain Medicine
J M López-González, S López-Álvarez, B M Jiménez Gómez, I Areán González, G Illodo Miramontes, L Padín Barreiro
INTRODUCTION: The aim of the study was to assess the effectiveness of ultrasound-guided transversalis fascia plane block (TFP) compared to anterior transversus abdominis plane block (TAP-A) for post-operative analgesia in outpatient unilateral inguinal hernia repair. MATERIALS AND METHODS: Retrospective observational study conducted on ASA I-II patients. Two groups (TAP-A and TFP), which were given 30ml of 0.25% levobupivacaine prior to surgical incision. The primary endpoint was the post-operative pain evaluated by verbal numerical scale (VRN at rest and movement) at 10, 30, 60, 90min, coinciding with ambulation, and 24hours by telephone...
November 2016: Revista Española de Anestesiología y Reanimación
Matthew Abrahams, Ryan Derby, Jean-Louis Horn
UNLABELLED: We summarized the evidence for ultrasound (US) guidance for truncal blocks in 2010 by performing a systematic literature review and rating the strength of evidence for each block using a system developed by the United States Agency for Health Care Policy and Research. Since then, numerous studies of US guidance for truncal blocks have been published. In addition, 3 novel US-guided blocks have been described since our last review. To provide updated recommendations, we performed another systematic search of the literature to identify studies pertaining to US guidance for the following blocks: paravertebral, intercostal, transversus abdominis plane, rectus sheath, ilioinguinal/iliohypogastric, as well as the Pecs, quadratus lumborum, and transversalis fascia blocks...
March 2016: Regional Anesthesia and Pain Medicine
Dimitrios K Manatakis, Nikolaos Stamos, Christos Agalianos, Michail Athanasios Karvelis, Michael Gkiaourakis, Demetrios Davides
We present two cases of patients who reported quadriceps femoris weakness and hypoesthesia over the anterior thigh after an inguinal hernia repair under transversus abdominis plane (TAP) block. Transient femoral nerve palsy is the result of local anesthetic incorrectly injected between transversus abdominis muscle and transversalis fascia and pooling around the femoral nerve. Although it is a minor and self-limiting complication, it requires overnight hospital stay and observation of the patients. Performing the block under ultrasound guidance and injecting the least volume of local anesthetic required are ways of minimizing its incidence...
2013: Case Reports in Anesthesiology
H Ludot
Although relatively few studies have compared US guidance with established "blind" techniques, the available evidence suggests that the use of US guidance is a safe and effective way to facilitate correct needle placement and adequate spread of LA for abdominal wall nerve blocks. It improves block effectiveness and safety by reducing LA doses and by detecting anatomic variants or unsuspected pathologies. Different techniques are described and discussed: the transverse abdominal nerve blocks, the paraombilical block, the inguinal field block and the fascia transversalis block...
January 2012: Annales Françaises D'anesthèsie et de Rèanimation
R C Read
Preperitoneal, a word coined by Nyhus in the 1960s, has been applied not only to posterior approaches that he, Stoppa, and Wantz popularized but to anterior exposures of the groin, which divide the transversalis fascia. This assumes that all give similar views of the easily cleaved space of Bogros. However, accumulated anatomical observations reveal the transversalis fascia as having not one but two layers. The inferior epigastric vessels run between rather than in the preperitoneal space, which is avascular and has its own fascia lining the peritoneum...
March 2005: Hernia: the Journal of Hernias and Abdominal Wall Surgery
D M Brooks
The psoas compartment acts as a conduit for the nerve roots of the lumbar plexus. Originating at approximately the 12th thoracic vertebrae, this potential compartment continues on caudally, bordered posterolaterally by fascia of the quadratus lumborum and iliacus muscles, medially by the fascia of the psoas major muscle, and anteriorly by the transversalis fascia. This natural "gutter" acts as a repository for local anesthetic agents and provides an excellent method of unilateral anterior lower extremity anesthesia...
May 2000: CRNA: the Clinical Forum for Nurse Anesthetists
T Saito, S Den, K Tanuma, Y Tanuma, E Carney, C Carlsson
An injection of a local anesthetics in the paravertebral region produces an analgesic field on the same side of the body, a paravertebral block. One point in question about this block is whether the local anesthetic spreads from the thoracic to the lumbar level of the paravertebral region. The purpose of this study was to find how the anesthetic fluid traveled to the lumbar paravertebral region, if at all. Twelve cadavers were used in this study. 15 ml of crimson dye was injected into the paravertebral region at the 11th thoracic level...
1999: Surgical and Radiologic Anatomy: SRA
D J Rosario, S Jacob, J Luntley, P P Skinner, A T Raftery
Femoral nerve palsy has been reported after percutaneous ilioinguinal field infiltration with general anaesthesia for inguinal herniorrhaphy. The mechanism whereby this could occur was studied in cadaver dissections. It was found that the plane between the transversus abdominis muscle and the transversalis fascia was continuous laterally with the tissue plane deep to the iliacus fascia, which is the plane containing the femoral nerve. Injection of methylene blue 1 ml into this plane resulted in pooling of dye around the femoral nerve...
March 1997: British Journal of Anaesthesia
A Wöhrmann-Repenning, B Ciba
An examination of 2 feline embryos in different stages of development (overall length 60 and 115 mm respectively) reveals a well developed vomeronasal complex in each case. Jacobson's Organs embedded within the paraseptal cartilage form long blind tubes at the base of the septum nasi. The cartilage is caudally tub-shaped and embraces rostrally completely the organ over a considerable length. In this manner a long, nearly tunnel-like tube is formed which represents a modified form of the original outer bar and which has not been described so far in cats...
1989: Gegenbaurs Morphologisches Jahrbuch
F D Salama
A new site for burying an implantable pacemaker in infants and young children is described. The Medtronic sutureless screw electrode is applied to the diaphragmatic surface of the heart through a transxiphoid approach. The unit is inserted in the abdominal wall between the transversalis fascia and the transversus muscle. The method is simple, taking approximately 30 minutes to complete. It avoids thoracotomy. The unit is well concealed and protected. The coils of the lead are relatively free from adhesions and allow for growth in the child...
June 1976: Thorax
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