Does the approach influence the success rate for ultrasound-guided rectus sheath blocks? An anatomical case series

Abstract

Ronald Seidel,1 Andreas Wree,2 Marko Schulze2 1Department of Anesthesiology and Intensive Care Medicine, HELIOS Medical Center Schwerin, Schwerin, 2Institute of Anatomy, Medical University of Rostock, Rostock, Germany Abstract: The anterior cutaneous branches of the thoracolumbar spinal nerves enter the rectus sheath at its lateral border and perforate the muscle after travelling a short distance in the ventral direction. In this anatomical case series, we show that dye injection at the medial margin did not lead to reliable impregnation of the target nerves. The local anesthetic should therefore be injected at the lateral edge of the rectus sheath. Preceding surgical procedures to the ventral abdominal wall may affect the craniocaudal spread of local anesthetic. Keywords: anesthesia, regional, ultrasonography, anatomic variation

Keywords

• Anesthesia
• Regional
• Ultrasonography
• Anatomic Variation