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.
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Rectus Sheath block
Started by Sonny Crocket
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Its a very easy block to do even in very obese patients, it just does not last as long as a TAP block.
Do you that TAP works just as well for umbilical hernias compares with rectus sheath?
I do them, works well.
It's 3-4cm deep in my patients usually
It's 3-4cm deep in my patients usually
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.
Rectus Sheath blocks which are single shot only last 6 hours. I don’t think single shot Rectus Sheath blocks are worth the trouble.
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.
I've never heard of a bowel perf from an abdominal plane block. Not sure if there are any case reports. It's a 22 GA needle. Be careful but not scared.
Rectus sheath block works for midline incisions but it does not last, it allows you to give less opiates intra-op if you do it pre-op though.
Surgeons purposefully place needles in the abdomen all the time for insufflation.
