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    Transversus abdominis plane block: a cadaveric and radiological evaluation.

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    Authors
    McDonnell, John G
    O'Donnell, Brian D
    Farrell, Thomas
    Gough, Niall
    Tuite, David
    Power, Camillus
    Laffey, John G
    Affiliation
    Department of Anaesthesia and Intensive Care Medicine, Galway University Hospitals, Tallaght, Dublin, Ireland.
    Issue Date
    2011-04-11T10:14:32Z
    MeSH
    Abdominal Wall
    Adult
    Anesthetics, Local
    Cadaver
    Humans
    Lidocaine
    Magnetic Resonance Imaging
    Male
    Methylene Blue
    Nerve Block
    Tomography, X-Ray Computed
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    Citation
    Transversus abdominis plane block: a cadaveric and radiological evaluation., 32 (5):399-404 Reg Anesth Pain Med
    Journal
    Regional anesthesia and pain medicine
    URI
    http://hdl.handle.net/10147/127932
    DOI
    10.1016/j.rapm.2007.03.011
    PubMed ID
    17961838
    Abstract
    The 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.
    Item Type
    Article
    Language
    en
    ISSN
    1098-7339
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.rapm.2007.03.011
    Scopus Count
    Collections
    Galway University Hospitals

    entitlement

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