Audit of initial use of the ultrasound-guided transversus abdominis plane block in children.

摘要: The extent of dermatomal block post transversus abdominis plane is described in adults as T7-L1; other authors argue above T10 infrequent (supra-iliac 20 ml injection). A paediatric guideline recommends this for upper and lower abdominal surgery using 0.2 ml/kg. We aimed (through prospective audit) to document the multi-level achieved with ultrasound-guided children having surgery, during a departmental training period. Data included patient, anaesthetic surgical details, characteristics (anterior supra-iliac injections) blockade ice. Twenty-seven received 38 blocks performed by 58% consultant 42% trainee operators (90% novices): 16 unilateral/11 bilateral umbilical (1), inguinal (13), laparoscopic (8) laparotomy (5) surgery. Dermatomal assessment 35 (mean local volume 0.4 ml/kg [SD 0.2]) revealed median was 3 dermatomes (interquartile range 4) involving L1 75% patients. Eight (six patients) also involved T8 T9, following 0.31 0.81 One patient (3% assessed blocks) had no ice at 60 minutes, but required postoperative analgesia. Ultrasound-guided approach novice produced sensory usually 4 dermatomes, should be offered only, only 25% extension. optimal dose/volume, duration effect utility these relation peripheral neuraxial needs clarification.