Ultrasound-Guided Peripheral Nerve Blocks: Abdominal Wall Nerve Blocks for Lower Abdominal Surgery

Abstract

  I.v. opioids, such as IV-PCA, are popular methods for postoperative pain control after lower abdominal surgery. However, opioids are weakly efficacious for somatic pain and are associated with side-effects including nausea, vomiting, and respiratory depression. It is well recognized that local anesthetic techniques can improve the quality of postoperative recovery by reducing the somatic pain and opioid requirement. Recently, the spread of ultrasound-guided nerve blocks has improved the efficacy of the abdominal wall blocks, such as TAP block, for example. Ultrasound-guided nerve blocks had been innovated for perioperative management for abdominal surgery, such as gynecologic laparotomy, laparoscopy-assisted surgery and inguinal hernia. The combination of abdominal nerve blocks and opioids allows a significant reduction in postoperative analgesics requirements and intraoperative relaxation of abdominal muscles.
  Further studies are warranted to establish general recommendations for the use of abdominal peripheral nerve blocks, as a part of a multimodal analgesic regimen for the quality of analgesia and patient satisfaction.