Ultrasound-guided para-umbilical block: a pediatric case

Published on Dec 1, 2017in JA Clinical Reports
· DOI :10.1186/s40981-017-0105-6
Masayuki Akatsuka2
Estimated H-index: 2
Takeshi Murouchi6
Estimated H-index: 6
+ 1 AuthorsMichiaki Yamakage9
Estimated H-index: 9
(Sapporo Medical University)
Background Rectus sheath block is a common peripheral nerve block for patients undergoing umbilical hernia repair surgery. However, rectus sheath block alone can affect only anterior branches of intercostal nerves and, therefore, is incomplete for postoperative analgesia for the anterior abdomen, which is innervated by both anterior and lateral branches. We describe a successful perioperative analgesia with ultrasound-guided para-umbilical block after pediatric umbilical hernia surgery.
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#2Víctor Götzens (University of Barcelona)H-Index: 7
Last. Maged MabrokH-Index: 3
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Summary Background : The most popular peripheral nerve blocks used in umbilical hernia repair are rectus sheath block and paraumbilical block. However, multiple anatomic variations have been described and some complications may occur. Ultrasonographic guidance of peripheral nerve blocks has reduced the number of complications and improved the quality of blocks. This case series describes a new ultrasound-guided puncture technique of the 10th intercostal nerve in pediatric umbilical surgery. Meth...
47 CitationsSource
#1Lok Huei Yap (Ninewells Hospital)H-Index: 1
#2John Howard Stevenson (Ninewells Hospital)H-Index: 1
Last. Alan Forster (Ninewells Hospital)H-Index: 2
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Summary Recent developments in autogenous breast reconstruction using the rectus abdominis myocutaneous free flap include attempts to reinnervate the flap tissue. We have carried out anatomical studies to determine the nature of abdominal-wall cutaneous innervation, with particular emphasis on the harvesting of sensate flaps. Dissections were performed on four embalmed and 12 fresh human cadavers (32 sides). The lowest five intercostal nerve trunks were identified and traced to the lateral borde...
47 CitationsSource
#1William M. SplinterH-Index: 24
#2Craig W. ReidH-Index: 4
Last. Juan BassH-Index: 14
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Background: The optimal method to achieve analgesia after inguinal hernia repair in children is unknown. This study compared the analgesic efficacy, adverse events, and the costs associated with supplementation of local anesthesia (infiltration of the wound) with either intravenous ketorolac or caudal analgesia in children having inguinal hernia repair. Methods: With parental consent and institutional review board approval, children aged 2-6 yr having elective, outpatient inguinal hernia repair ...
50 CitationsSource
#1P. CourregesH-Index: 1
#2F PoddevinH-Index: 1
Last. D LecoutreH-Index: 3
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This preliminary study describes a new technique to provide analgesia in children undergoing umbilical hernia repair. The para-umbilical block consists of infiltrating the anterior cutaneous branches of the two tenth spinal roots over and under the rectus sheath far from the operative field. Intra and postoperative analgesia as well as operative conditions were assessed in 11 children 16.7±31 months old, weighing 8421±6941 g, the block being performed before surgery under light general anaesthes...
62 CitationsSource
#1S. Ferguson (University of Southampton)H-Index: 1
#2V.L. Thomas (University of Southampton)H-Index: 2
Last. I.H. Lewis (University of Southampton)H-Index: 1
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The rectus sheath block has been used with success for postoperative analgesia in adults. This paper reviews the anatomy of the rectus sheath, and presents our initial experience of using the block to provide intra- and postoperative analgesia in children having repair of umbilical and paraumbilical hernia. The rectus sheath block appears to be a useful technique in children, particularly for paediatric day-case surgery.
77 CitationsSource
#1H. Sakamoto (Tokyo Medical and Dental University)H-Index: 3
#2Keiichi Akita (Tokyo Medical and Dental University)H-Index: 27
Last. T. Sato (Tokyo Medical and Dental University)H-Index: 1
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Minute dissection was performed in one male adult cadaver in order to elucidate the detailed distribution of muscular branches of intercostal nerves within the lateral abdominal muscles as well as the segmental relationships. In the obliquus internus and transversus abdominis, as well as in the upper half of the obliquus externus, each muscle fascicle receives the nerve of the corresponding segmental attachment to the rib. On the other hand, in the lower half, the obliquus externus abdominis rec...
16 CitationsSource
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