Dermatomal spread following posterior transversus abdominis plane block in pediatric patients: our initial experience

• DOI: 10.1111/pan.13034
• Publication Date: 2017-01-18T10:17:02Z
• Authors: Maria A. Hernandez; Tricia Vecchione; Karen Boretsky
• Keywords: Transversus abdominis

Abstract Introduction Several techniques for the transversus abdominis plane ( TAP ) block have been described. The extent of sensory changes using an ultrasound‐guided posterior pTAP remains unclear in pediatric patients. primary aim this study was to report achieved with ; specifically highest thoracic dermatome anesthetized. Secondary outcomes were pain scores PS ), opioid consumption, and complications. Methods We retrospectively reviewed medical records patients less than 21 years age undergoing abdominal surgery a unilateral or bilateral (s) postoperative analgesia. local anesthetic placed termination muscle where thoracolumbar fascia overrides quadratus lumborum muscle. changes, scores, consumption analyzed. Results A total 10 (15 blocks) met inclusion criteria. mean sd range) weight 15 (5 years; range 7–20 years) 57 kg (21 kg; 27–97 kg), respectively. cephalad levels were: T7 6/15 (40%); T8 10/15 (67%); T9 14/15 (93%). An inferior level T12/L1 extension from midaxillary line midline documented 15/15 blocks. intraoperative postanesthesia care unit PACU morphine equivalents 0.34 mg·kg −1 = 0.12 0.04 0.05 mild (<4) 60%, moderate (4–7) 30%, severe (>7) 10% No complications reported. Discussion current uncertainty regarding blockade limits clinical application While approach results unpredictable abdomen, we reliably up 93% Conclusion In small series patients, demonstrate high technical success rate achieving cutaneous analgesia wall. These should encourage studies efficacy