Rectus Sheath block

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Anyone do these for umbilical hernia repair? I know that you are supposed to inject into the posterior fascia of the rectus abdominus. But it is a bit scary going that deep with the bowel right underneath.
Its a very easy block to do even in very obese patients, it just does not last as long as a TAP block.
 
Tap blocks work well for umbilical hernia repairs. I prefer a 4 quadrant technique to make sure there is analgesia above the umbilicus.

Rectus Sheath blocks which are single shot only last 6 hours. I don’t think single shot Rectus Sheath blocks are worth the trouble.
 
Anyone do these for umbilical hernia repair? I know that you are supposed to inject into the posterior fascia of the rectus abdominus. But it is a bit scary going that deep with the bowel right underneath.

The trick is to enter the skin a good distance away from your US probe with a long needle, this way your angle of entry is shallow and you easily slide your way into the space deep to the rectus without going too deep.
 
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