Predictors of Difficult Ultrasound-Guided Transversus Abdominis Plane Blocks.

Kyle Bellamy,Bryan J Hierlmeier,Tom Stockman,Oscar A Alam Mendez,Kenneth Oswalt

doi:10.7759/cureus.18445

Abstract

BackgroundFascial plane blocks are a valuable and important aspect of patient care. However, nerve blocks sometimes present with a technical difficulty that can lead to upsetting the operating room schedule, cause discomfort to the patient, or lead to inadequate block. Potential predictors of this difficulty were evaluated.MethodsIn a single-blind study, ultrasound image quality was evaluated on a grading metric, and its correlation with several factors that could potentially impact the difficulty of a procedure, including age, BMI, weight, length of surgery, IV fluids, and pre- vs postoperative block, was assessed.ResultsNo correlation was found between any of our anesthetic, patient, or surgical factors, and the resulting image quality.ConclusionThe study population was limited compared to our initial goals. We found no correlation between studied variables and image quality, but confounding factors that may affect image quality have not been ruled out.

Highlights

Regional anesthesia is a key tool in patient care in both the operative and nonoperative settings
Nerve blocks sometimes present with a technical difficulty that can lead to upsetting the operating room schedule, cause discomfort to the patient, or lead to inadequate block
In a single-blind study, ultrasound image quality was evaluated on a grading metric, and its correlation with several factors that could potentially impact the difficulty of a procedure, including age, BMI, weight, length of surgery, IV fluids, and pre- vs postoperative block, was assessed

Summary

Introduction

Regional anesthesia is a key tool in patient care in both the operative and nonoperative settings. It plays a role in pain management and as a primary anesthetic. The purpose of the block, the patient's need for pain control, and the mode of anesthetic administration are all examples of factors that play a role in optimal patient care. Nerve blocks sometimes present with a technical difficulty that can lead to upsetting the operating room schedule, cause discomfort to the patient, or lead to inadequate block. Potential predictors of this difficulty were evaluated

Methods

Discussion

Conclusion