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

Authors Seidel R, Wree A, Schulze M

Received 30 January 2017

Accepted for publication 27 April 2017

Published 5 July 2017 Volume 2017:10 Pages 61—65

DOI https://doi.org/10.2147/LRA.S133500

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr Stefan Wirz


Supplementary video of the in-plane technique from lateral to medial (right side).

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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

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