NYSORA 4 U (N4U): What’s New

A Cadaveric Study Investigating the Subcostal Transversus Abdominis Plane Block: Comparing Single and Sequential Injections

The subcostal transversus abdominis plane block (scTAPB) offers anterior abdominal wall analgesia, but single injections often yield modest and variable spread. The oblique scTAPB, involving continuous injection along the oblique subcostal line, aims for broader coverage but faces challenges with hydrodissection. This cadaveric study explored whether two sequential scTAPB injections (2scTAPI) could reach more nerves than a single injection (1scTAPI). Dye injections were performed in cadavers, with 2scTAPI demonstrating a significantly wider spread at the costal margin compared to 1scTAPI, suggesting greater coverage of abdominal wall nerves. Clinical validation is necessary to confirm these findings.

2scTAPI on the left side of the subject (green dye) and 1scTAPI on the right side (blue dye). 1scTAPI, subcostal transversus abdominis plane injections using either one; EO, external oblique muscle, IO, internal oblique muscle, RA, rectus abdominis muscle, K8, K9, K10: ribs no 8, 9 and 10; TA: transversus abdominis muscle.

To read the full paper in RAPM, copy-paste this into your Google search: 

Schaefer A, Grousson S, Bessede T, Benhamou D, Ruscio L. Subcostal TAP block: one or two sequential injections? A cadaveric study. Reg Anesth Pain Med. Published online February 23, 2024.

https://rapm.bmj.com/content/early/2024/02/23/rapm-2023-105079