Transversus abdominis plane block: a cadaveric and radiological evaluation.
AuthorsMcDonnell, John G
O'Donnell, Brian D
Laffey, John G
AffiliationDepartment of Anaesthesia and Intensive Care Medicine, Galway University Hospitals, Tallaght, Dublin, Ireland.
Magnetic Resonance Imaging
Tomography, X-Ray Computed
MetadataShow full item record
CitationTransversus abdominis plane block: a cadaveric and radiological evaluation., 32 (5):399-404 Reg Anesth Pain Med
JournalRegional anesthesia and pain medicine
AbstractThe abdominal wall is a significant source of pain after abdominal surgery. Anterior abdominal wall analgesia may assist in improving postoperative analgesia. We have recently described a novel approach to block the abdominal wall neural afferents via the bilateral lumbar triangles of Petit, which we have termed a transversus abdominis plane block. The clinical efficacy of the transversus abdominis plane block has recently been demonstrated in a randomized controlled clinical trial of adults undergoing abdominal surgery.
After institutional review board approval, anatomic studies were conducted to determine the deposition and spread of methylene blue injected into the transversus abdominis plane via the triangles of Petit. Computerized tomographic and magnetic resonance imaging studies were then conducted in volunteers to ascertain the deposition and time course of spread of solution within the transversus abdominis fascial plane in vivo.
Cadaveric studies demonstrated that the injection of methylene blue via the triangle of Petit using the "double pop" technique results in reliable deposition into the transversus abdominis plane. In volunteers, the injection of local anesthetic and contrast produced a reliable sensory block, and demonstrated deposition throughout the transversus abdominis plane. The sensory block produced by lidocaine 0.5% extended from T7 to L1, and receded over 4 to 6 hours, and this finding was supported by magnetic resonance imaging studies that showed a gradual reduction in contrast in the transversus abdominis plane over time.
These findings define the anatomic characteristics of the transversus abdominis plane block, and underline the clinical potential of this novel block.
- Studies on the spread of local anaesthetic solution in transversus abdominis plane blocks.
- Authors: Carney J, Finnerty O, Rauf J, Bergin D, Laffey JG, Mc Donnell JG
- Issue date: 2011 Nov
- Ultrasound-guided transversus abdominis plane block in the dog: an anatomical evaluation.
- Authors: Schroeder CA, Snyder LB, Tearney CC, Baker-Herman TL, Schroeder KM
- Issue date: 2011 May
- [Axillary local anesthetic spread after the thoracic interfacial ultrasound block - a cadaveric and radiological evaluation].
- Authors: Torre PA, Jones JW Jr, Álvarez SL, Garcia PD, Miguel FJG, Rubio EMM, Boeris FC, Sacramento MK, Duany O, Pérez MF, Gordon BQ
- Issue date: 2017 Nov - Dec
- Transversus abdominis plane block versus perioperative intravenous lidocaine versus patient-controlled intravenous morphine for postoperative pain control after laparoscopic colorectal surgery: study protocol for a prospective, randomized, double-blind controlled clinical trial.
- Authors: Dewinter G, Van de Velde M, Fieuws S, D'Hoore A, Rex S
- Issue date: 2014 Dec 4
- An anatomical study of the transversus abdominis plane block: location of the lumbar triangle of Petit and adjacent nerves.
- Authors: Jankovic ZB, du Feu FM, McConnell P
- Issue date: 2009 Sep