Transversus abdominis plane block

CHAPTER 34 Transversus abdominis plane block

Clinical anatomy

The sensory innervation of the abdominal wall is derived from the sixth thoracic nerve to the first lumbar nerve (Fig. 34.1). The nerves arise from the ventral rami of their respective nerve roots and travel anteriorly in a groove beneath the respective ribs to lie between the internal intercostal muscle and the innermost intercostal muscle. The intercostal nerve gives a sensory branch at the mid-axillary line, which provides variable innervation from the posterior axillary line anteriorly. The nerve continues forward as the anterior cutaneous branch, which enters the transversus abdominis plane of the anterior abdominal wall and supplies the skin, muscles and parietal peritoneum in the abdomen (Fig. 34.2). The transversus abdominis plane (TAP) lies between the internal oblique and transversus abdominis muscles, and forms a connective tissue conduit through which the ventral rami of T6 to L1 travel. Deposition of local anesthetic solution in the TAP permits abdominal wall sensory blockade.

Jul 28, 2016 | Posted by in ANESTHESIA | Comments Off on Transversus abdominis plane block
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