Ultrasound Blocks for the Anterior Abdominal Wall
Ultrasound Blocks for the Anterior Abdominal Wall
Ultrasound Blocks for the Anterior Abdominal Wall
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50 | <strong>Ultrasound</strong> <strong>Blocks</strong> <strong>for</strong> <strong>the</strong> <strong>Anterior</strong> <strong>Abdominal</strong> <strong>Wall</strong><br />
may be seen corresponding to <strong>the</strong> IHN and IIN. The IIN is <strong>the</strong><br />
closest to <strong>the</strong> iliac bone.<br />
Figure 4.2 – Positioning <strong>for</strong> ultrasound-guided block per<strong>for</strong>mance.<br />
The needle is inserted with an in-plane approach, parallel and<br />
aligned to <strong>the</strong> long axis of <strong>the</strong> transducer. The needle is<br />
advanced obliquely. The in-plane approach would possibly<br />
decrease <strong>the</strong> risk of advancing <strong>the</strong> needle into <strong>the</strong> peritoneal<br />
cavity. Always control <strong>for</strong> blood vessels and aspirate be<strong>for</strong>e<br />
injecting.<br />
<strong>Ultrasound</strong>s have been shown to decrease local anes<strong>the</strong>tic<br />
volume and improve <strong>the</strong> success of <strong>the</strong> block (Willschke 2005,<br />
Willschke 2006, Eichenberger 2009). <strong>Ultrasound</strong> guidance<br />
enhances efficacy and safety. The main disadvantages are <strong>the</strong><br />
cost of equipment and <strong>the</strong> need <strong>for</strong> adequate training of
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