Key result
Abdominal wall blocks, including transversus abdominis plane (TAP) block and quadratus lumborum block, are increasingly used as alternatives to thoracic epidural analgesia for postoperative pain.
Why the study?
Postoperative analgesia for abdominal surgery is shifting from epidural anesthesia to peripheral nerve blocks due to minimally invasive surgery and anticoagulant therapy, necessitating an understanding of abdominal neuroanatomy and key procedural considerations.
Provides an anatomical and technical overview of ultrasound-guided abdominal wall blocks, which are increasingly used for postoperative analgesia in minimally invasive abdominal surgeries.
May aid block implementation in abdominal surgery; leaves open comparative RCTs versus epidural.
腹部手術の術後鎮痛が硬膜外麻酔から末梢神経ブロックに移行しつつある．低侵襲手術の普及や抗凝固療法の拡大がその引き金となっている．超音波ガイド下末梢神経ブロックの初期から腹直筋鞘ブロックと腹横筋膜面（tap）ブロックが腹部の麻酔のために使用され始めた．その後，より広範囲の効果を得るために肋骨弓下tapブロックが発表され，この数年は腰方形筋ブロック（qlb）が注目されている．今回はこれらのブロックの理解に必要な腹部の神経解剖と，神経ブロックを行う際に注意すべき点を紹介する．
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Atsushi Hashimoto (2019) conducted a review in Postoperative pain management for abdominal surgery. Abdominal wall blocks (TAP block, Quadratus lumborum block) vs. Thoracic epidural analgesia (historical context) was evaluated. Abdominal wall blocks, including transversus abdominis plane (TAP) block and quadratus lumborum block, are increasingly used as alternatives to thoracic epidural analgesia for postoperative pain.
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