Spread patterns and effectiveness for surgery after ultrasound-guided rectus sheath block in adult day-case patients scheduled for umbilical hernia repair

Journal of Anaesthesiology, Clinical Pharmacology
Alberto ManasseroLuca Bertolaccini

Abstract

We conducted a prospective study to examine the local anesthetic (LA) spread and the effectiveness for surgical anesthesia of ultrasound (US)-guided rectus sheath block (RSB) in adult patients undergoing umbilical hernia repair. Thirty patients received at T-10 level a bilateral US-guided injection of 20 mL levobupivacaine 0.375% + epinephrine 5 μg/mL behind the rectus muscle to detach it from its sheath. Anesthetic spread into the rectus sheath was evaluated ultrasonographically at T-9 and T-11 levels and scored from 0 to 4. The RSB was defined effective for surgical anesthesia if it was able to guarantee an anesthetic level sufficient for surgery without any mepivacaine supplementation. Overall, the block was effective for surgical anesthesia in 53.3% of patients (95% confidence interval, ±17.8). In the remaining patients, anesthesia supplementation was needed at cutaneous incision, whereas manipulation of the muscle and fascial planes was painless. No patients required general anesthesia. LA spreads as advocated (to T-9 and to T-11 bilaterally = spread score 4) in 8/30 patients (26.6%); in these cases, the block was 75% effective for surgery. The anesthetic spread was most negatively influenced by increased body mass index. ...Continue Reading

References

Sep 1, 1996·Anaesthesia·J Muir, S Ferguson
Jan 1, 1997·Paediatric Anaesthesia·P CourregesD Lecoutre
May 21, 2005·Journal of Minimally Invasive Gynecology·Simin Azemati, M B Khosravi
Apr 19, 2006·Paediatric Anaesthesia·Lisa A IsaacMark W Crawford
Dec 23, 2006·Paediatric Anaesthesia·Belen de Jose MariaMaged Mabrok
Feb 14, 2007·ANZ Journal of Surgery·Philip Cornish, Alf Deacon
Jun 6, 2009·Hernia : the Journal of Hernias and Abdominal Wall Surgery·F E MuysomsA Kingsnorth
Apr 14, 2010·Anaesthesia·O FinnertyJ G McDonnell
Jun 23, 2011·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Randall MalchowHumphrey Lam
Oct 6, 2012·Regional Anesthesia and Pain Medicine·Marcia A CorvettoFernando R Altermatt

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BETA
sedation

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