Combination of Rectus Sheath Block and Subcostal Transversus Abdominis Plane Block as the Sole Anesthesia for an Open Gastrostomy in a High-risk Patient

Authors

  • Aumjit Wittayapairoj Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
  • Jedniphat Intrapongpan Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
  • Saran Thanharak Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.

DOI:

https://doi.org/10.31584/jhsmr.2023999

Keywords:

open gastrostomy, rectus sheath block, regional anesthesia, transversus abdominis plane block, truncal block

Abstract

Truncal blocks are widely used for postoperative analgesia, but are rarely used for surgical anesthesia. Herein is reported the success of an open gastrotomy under truncal blocks in a patient for whom general anesthesia and neuraxial blockade were undesirable. A 79-year-old man, with advanced esophageal cancer presented with several comorbidities; including cardiomyopathy, ischemic heart disease, and prior cerebral infarction. Difficulty in airway management was anticipated due to the mass’s compression on the airway. Anesthesia was achieved using a combination of truncal blocks; this being the rectus sheath block and the subcostal transversus abdominis plane block, supplemented by intravenous fentanyl for managing visceral pain.

References

Faria GR, Taveira-Gomes A. Open gastrostomy by minilaparotomy: A comparative study. Int J Surg 2011;9:263–6.

Lee AR, Choe YS. Anesthesia experience for open gastrostomy with ultrasound-guided unilateral subcostal transversus abdominis plane block in a high risk elderly patient: a case report. Anesth Pain Med 2015;5:e24890.

Chakraborty A, Khemka R, Datta T. Ultrasound‑guided truncal blocks: A new frontier in regional anaesthesia. Indian J Anaesth 2016;60:703–11.

Ruiz-Chirosa MDC, Nieto-Martín L, García-Fernández E, Vaquero-Roncero LM, Sánchez-Montero JM, Alonso-Guardo L, et al. Epidural anesthesia for open gastrostomy in a patient with amyotrophic lateral sclerosis. Rev Colomb Anestesiol 2018;46:246–9.

Li Q, Tang X, Tao T, Zhang W, Qin W, Zhang J, et al. A randomized controlled trial of comparing ultrasound-guided transversus abdominis plane block with local anesthetic infiltration in peritoneal dialysis catheter implantation. Blood Purif 2018;45:8–14.

Soliz JM, Lipski I, Hancher-Hodges S, Speer BB, Popat K. Subcostal transverse abdominis plane block for acute pain management: a review. Anesth Pain Med 2017;7:e12923.

Kartalov A, Jankulovski N, Kuzmanovska B, Zdravkovska M, Shosholcheva M, Tolevska M, et al. The effect of rectus sheath block as a supplement of general anesthesia on postoperative analgesia in adult patient undergoing umbilical hernia repair. Prilozi 2017;38:135–42.

Quek KHY, Phua DSK. Bilateral rectus sheath block as the single anaesthetic technique for an open infraumbilical hernia repair. Singapore Med J 2014;55:39–41.

Lissauer J, Mancuso K, Merritt C, Prabhakar A, Kaye AD, Urman RD. Evolution of the transversus abdominis plane block and its role in postoperative analgesia. Best Pract Res Clin Anaesthesiol 2014;28:117–26.

Li J, Guo W, Zhao W, Wang X, Hu W, Zhou J, et al. Ultrasoundguided unilateral transversus abdominis plane combined with rectus sheath block versus subarachnoid anesthesia in patients undergoing peritoneal dialysis catheter surgery: a randomized prospective controlled trial. J Pain Res 2020;13:2279–87.

Kalava A, Chambers TJ, Hoffman JF. Bilateral thoracic paravertebral nerve blocks for open gastrostomy in patients with amyotrophic lateral sclerosis. Cureus 2020;12:10–2.

Bagaphou CT, Piraccini E, Norgiolini L, Ciabucchi C, Carsena V, et al. Anesthesia experience for open gastrostomy with ultrasound-guided erector spinae plane block: a case report. Case Rep Anesthesiol 2020;2020:5413848.

Wittayapairoj A, Sinthuchao N, Somintara O, Thincheelong V, Somdee W. A randomized double-blind controlled study comparing erector spinae plane block and thoracic paravertebral block for postoperative analgesia after breast surgery. Anesth Pain Med 2022;17:445–53.

Simpson J, Ariyarathenam A, Dunn J, Ford P. Breast surgery using thoracic paravertebral blockade and sedation alone. Anesthesiol Res Pract 2014;2014:127467.

Bejrananda T, Pakpirom J. Successful percutaneous nephrolithotomy using thoracic paravertebral block as the sole surgical anesthesia: cases report. J Health Sci Med Res 2021; 39:423-9.

Downloads

Published

2023-11-20

How to Cite

1.
Wittayapairoj A, Intrapongpan J, Thanharak S. Combination of Rectus Sheath Block and Subcostal Transversus Abdominis Plane Block as the Sole Anesthesia for an Open Gastrostomy in a High-risk Patient. J Health Sci Med Res [Internet]. 2023 Nov. 20 [cited 2024 Jul. 18];42(1):e2023999. Available from: https://he01.tci-thaijo.org/index.php/jhsmr/article/view/267239

Issue

Section

Case Report