Regional Anesthesia for Thoracic and Abdominal Surgery: Tips and Tricks for the Surgeon

Am Surg. 2023 Feb;89(2):183-191. doi: 10.1177/00031348221109499. Epub 2022 Jul 7.

Abstract

The use of ultrasound-guided regional anesthesia (UGRA) has flourished over the past two decades with the description of many novel techniques and the incorporation of UGRA into patient care pathways for many types of surgery, including thoracic and abdominal surgery. Numerous facial plane blocks have been developed for analgesia of the chest and abdomen. Though analgesic efficacy varies based on the specific technique, it is important to be aware of the regional anesthesia techniques in common usage, their analgesic distributions, side effect profiles, and efficacy. In this review, we describe fascial plane blocks developed since 2010 as well as older regional anesthesia techniques and provide context for how and why they might be incorporated into patient care pathways. We will provide salient details on block coverage and briefly discuss evidence and relevant controversies around their use.

Keywords: Anatomy; Enhanced Recovery Pathways, Regional anesthesia, Nerve block; Surgical Quality.

Publication types

  • Review

MeSH terms

  • Anesthesia, Conduction* / methods
  • Humans
  • Nerve Block* / methods
  • Pain Management
  • Pain, Postoperative / prevention & control
  • Surgeons*
  • Ultrasonography, Interventional