title: [Ultrasound-guided subcostal and mid-axillary transverus abdominis plane block: a cadaveric study of the spread of injectate].
abstract: BACKGROUND
  Mid-axillary transversus abdominis plane block (TAP-B) and subcostal TAP-B have become well-known blocks to provide considerable analgesia for abdominal surgery. However, proper approach and adequate volume of injectate have not still been clarified. In this study, a combination of mid-axillary TAP-B and subcostal TAP-B was performed in cadavers to establish the spread of injectate and segmental nerve involvement.
  
  
  METHODS
  Ultrasound-guided dye injections (10 ml each) into the TAP were performed with mid-axillary and subcostal approaches. Injections were performed for hemiabdominal walls of 4 Thiel's embalmed human cadavers. Dye spread and nerve involvement were evaluated by dissection 10 min after the injections.
  
  
  RESULTS
  All 7 hemiabdominal walls were successfully injected and dissected after 1 pilot study. Thoracic nerves (T7-12) and the first lumbar nerve (L1) were found. Segmental nerves T7 (14%), T8-11 (100%), T12 (71%), and L1 (43%)were involved.
  
  
  CONCLUSIONS
  This study demonstrated that the combination of ultrasound-guided mid-axillary TAP-B and subcostal TAP-B involve T8-L1 nerves. This technique can be used not only in lower abdominal surgery but also in upper abdominal surgery.
authors: Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo 060-8543.
authors: Takeshi
authors: T
authors: Murouchi
authors: Masanori
authors: M
authors: Yamauchi
authors: Eri
authors: E
authors: Gi
authors: Yukimasa
authors: Y
authors: Takada
authors: Aki
authors: A
authors: Mizuguchi
authors: Michiaki
authors: M
authors: Yamakage
authors: Mineko
authors: M
authors: Fujimiya
mesh_terms: D000009:Abdominal Muscles / Q000000981:diagnostic imaging / Q000294:innervation*; D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D004396:Coloring Agents; D006801:Humans; D007267:Injections; D009407:Nerve Block / Q000379:methods*; D014463:Ultrasonography
chemical_list: D004396:Coloring Agents