Aǧrı : Ağrı (Algoloji) Derneği'nin Yayın organıdır = The journal of the Turkish Society of Algology
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There has been an increasing trends in the procedures of spine surgery in recent years. Postoperative chronic pain in spine surgery can be caused by damage or instability of spinal column; pressure on nerves or segment of spinal cord; or can be due to long lasting nociception caused by inflammation, infection or tumour. ⋯ Coping with any type of chronic pain is quite difficult. Chronic postoperative pain can be treated with: NSAIDs, paracetamol, opioids, anticonvulsants and invasive technics such as nerve blocs, central blocs.
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Case Reports
Ultrasound guided TAP block for the treatment of postoperative prolonged pain - an alternative approach.
Transversus abdominis plane (TAP) block is a relatively new regional anesthesia technique in which T7-12 intercostal nerves, ilioinguinal and iliohypogastric nerves, and cutaneous branches of L1-3 nerves are blocked between the internal oblique and transversus abdominis muscles. This technique is mostly used for the treatment of acute postoperative pain following abdominal surgery. In this case report, we evaluate the usage of TAP block in prolonged pain following upper abdominal surgery.
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Using low doses of local anesthetic, ultrasound guided multiple nerve blocks were performed in a high-risk patient. Surgical anesthesia was provided in an ASA III classified patient who received ultrasound guided right femoral and bilateral popliteal blocks. ⋯ Visualization of nerves by ultrasound guidance increases block success rate and contributes to lower local anesthetic doses. Using lower doses of local anesthetic during ultrasound-guided blocks allows multiple blocks to be performed safely.