Rectus Sheath Block - A How-To Guide
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- Опубліковано 3 тра 2022
- Technique description starts at 1:43.
This is meant to be a quick refresher to review just ahead of performing the block, and assumes you are familiar with the indications, and contraindications to the technique.
This video is for informational and educational purposes only. It is not a substitute for professional medical advice, or consultation with a health care professional.
Excellent video. Thank you Dr.Chin
Legend
Hi prof! Iwould like to clarify if there’s a typo in the slide from 2:11 onwards under ‘Approach: In plane medial to lateral’? It was recommended earlier in the video for a lateral approach.
Well spotted! You are absolutely right! It should be lateral to medial.
Hello Dr Chin, between this block and Tap block which one is recommended for the midline Laparatomies ? and why, Thank you
TAP would not cover mid line incision. You would either need rectus sheath blocks or QL blocks.
Doing these for a few years I always wondered why people don't talk about doing them parasagittal in plane instead for transverse in plane. Especially for single shots when you want to cover as much real estate with your local as possible - using parasagittal you can see your local spreading down the sheath and keep advancing your needle. Why do transverse in plane when you said yourself the nerves are on the lateral aspect of the RA.
I think the main reason the transverse IP approach is so widely taught is that it is the most accessible "beginner" technique. The anatomy of the edge of the rectus abdominis is easily recognized. Any blood vessels present are also visible in cross-section and easier to spot. I do agree with you about the needle orientation ideally being parallel to the rectus abdominis itself.
IMO a great hybrid approach would be to identify the lateral edge in a transverse view, pick your parasagittal "line" and needle insertion point, then rotate the probe into a longitudinal view, and advance needle in-plane as you suggest.