Three different approaches to Transversus abdominis plane
Aim The transversus abdominis plane (TAP) block is a new techniquefor providing analgesia to the anterior abdominal wall. There is ongoing debate regarding access point for TAP block. The aim of this cadaveric study was to compare the spread of 40 mL of dye using three different approaches to TAP: s...
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Medical Association of Zenica-Doboj Canton
2011-08-01
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doaj-a1aafa8a5eed49a7a4d3822ab6929b272020-11-24T22:39:49ZengMedical Association of Zenica-Doboj CantonMedicinski Glasnik1840-01321840-24452011-08-0182181184Three different approaches to Transversus abdominis planeZoka MilanDominic TaborPatricia McConnellJames PickeringMitko KocarevFrances du FeuSarah BartonAim The transversus abdominis plane (TAP) block is a new techniquefor providing analgesia to the anterior abdominal wall. There is ongoing debate regarding access point for TAP block. The aim of this cadaveric study was to compare the spread of 40 mL of dye using three different approaches to TAP: subcostal , via the mid-axillary and via the lumbar triangle of Petit (LTOP). Methods Injection of black dye into the TAP was performed for each hemi-abdominal wall of 13 embalmed human cadavers by using 3 different access points: subcostal (9 hemi-abdomens), mid-axillary (9) and LTOP (8). This was followed by dissection to determine the extent of dye spread and nerve involvement in the dye injection. The shapes of the dye were traced onto clear plastic, which was then photographed. These digital photographs were loaded into the mathematical software programme Matlab, and the outline of the dye spread was digitised using a piecewise cubic spline, enabling the shapes to be plotted on a graph and the areas to be calculated. Results The area of the dye spread for subcostal, mid-axillary and LTOP was 85.1 (T7-L1), 58.9 (T10-L1) and 77.9cm2 (T10-L1), respectively. There was statistically significant difference between area of dye spread between subcostal and mid-axillary approach (p<0.01). Conclusion This dye injection study in a cadaver model indicates that subcostal approach is associated with a larger area of spread of dye than the mid-axillary approach. Dye injected through subcostal, mid-axillary and LTOP approaches demonstrated different nerve involvement.http://www.ljkzedo.com.ba/medglasnik/vol82/MGvol82.2011_2.pdf |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Zoka Milan Dominic Tabor Patricia McConnell James Pickering Mitko Kocarev Frances du Feu Sarah Barton |
spellingShingle |
Zoka Milan Dominic Tabor Patricia McConnell James Pickering Mitko Kocarev Frances du Feu Sarah Barton Three different approaches to Transversus abdominis plane Medicinski Glasnik |
author_facet |
Zoka Milan Dominic Tabor Patricia McConnell James Pickering Mitko Kocarev Frances du Feu Sarah Barton |
author_sort |
Zoka Milan |
title |
Three different approaches to Transversus abdominis plane |
title_short |
Three different approaches to Transversus abdominis plane |
title_full |
Three different approaches to Transversus abdominis plane |
title_fullStr |
Three different approaches to Transversus abdominis plane |
title_full_unstemmed |
Three different approaches to Transversus abdominis plane |
title_sort |
three different approaches to transversus abdominis plane |
publisher |
Medical Association of Zenica-Doboj Canton |
series |
Medicinski Glasnik |
issn |
1840-0132 1840-2445 |
publishDate |
2011-08-01 |
description |
Aim The transversus abdominis plane (TAP) block is a new techniquefor providing analgesia to the anterior abdominal wall. There is ongoing debate regarding access point for TAP block. The aim of this cadaveric study was to compare the spread of 40 mL of dye using three different approaches to TAP: subcostal , via the mid-axillary and via the lumbar triangle of Petit (LTOP). Methods Injection of black dye into the TAP was performed for each hemi-abdominal wall of 13 embalmed human cadavers by using 3 different access points: subcostal (9 hemi-abdomens), mid-axillary (9) and LTOP (8). This was followed by dissection to determine the extent of dye spread and nerve involvement in the dye injection. The shapes of the dye were traced onto clear plastic, which was then photographed. These digital photographs were loaded into the mathematical software programme Matlab, and the outline of the dye spread was digitised using a piecewise cubic spline, enabling the shapes to be plotted on a graph and the areas to be calculated. Results The area of the dye spread for subcostal, mid-axillary and LTOP was 85.1 (T7-L1), 58.9 (T10-L1) and 77.9cm2 (T10-L1), respectively. There was statistically significant difference between area of dye spread between subcostal and mid-axillary approach (p<0.01). Conclusion This dye injection study in a cadaver model indicates that subcostal approach is associated with a larger area of spread of dye than the mid-axillary approach. Dye injected through subcostal, mid-axillary and LTOP approaches demonstrated different nerve involvement. |
url |
http://www.ljkzedo.com.ba/medglasnik/vol82/MGvol82.2011_2.pdf |
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