Block It Like It’s Hot S2:E4 "Top Tap Tips for Tums: Abdominal Wall Blocks (Part 1)"
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May 15, 2024 Join hosts Amit and Jeff as they dive into the world of abdominal wall blocks, discussing anatomy, clinical decision-making, and tips for optimal outcomes. From exploring different block techniques to the evolution of analgesia methods in surgery, this episode is packed with informative and humorous banter. Learn about rectus, subcostal, and TAP blocks, and how to navigate the challenges of needle placement and continuous movement for postoperative comfort.
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Shift from Thoracic Epidurals
- Thoracic epidurals, once the gold standard for major abdominal surgery opioid analgesia, have declined due to management challenges.
- Hypotension and lack of post-op support limit their use, shifting practice towards fascial plane blocks.
John McDonald's TAP Block Story
- John McDonald discovered the TAP block while addressing lack of ICU beds for major abdominal surgery patients.
- His patient reportedly felt so good post-op, she was smoking outside hospital the next day, illustrating profound analgesic effect.
Somatic vs Visceral Analgesia Blocks
- Fascial plane blocks like TAP and rectus sheath mainly provide somatic analgesia.
- Blocks like quadratus lumborum and ESP may provide visceral analgesia due to paravertebral spread.