title: [Efficacy of repeated subcostal transversus abdominis plane blocks with 0.2% lidocaine via 18-gauge intravenous catheters for patients undergoing abdominal aortic aneurism surgery].
abstract: BACKGROUND
  There is an increasing number of patients scheduled for abdominal aortic aneurysm resection in whom epidural anesthesia cannot be performed because of concomitant antiplatelet/anticoagulant therapy. Instead of epidural anesthesia for postoperative analgesia in such patients it is possible to use repeated bilateral subcostal transversus abdominis plane (TAP) blocks.
  
  
  METHODS
  Four patients receiving antiplatelet/anticoagulant therapy for abdominal aortic aneurysm resection under general anesthesia were studied. After the completion of surgery and before emergence from anesthesia 18-gauge intravenous catheters were inserted bilaterally into subcostal TAP and 100 ml (50 ml on each side) of 0.2% lidocaine with 1/500,000 epinephrine were injected via the catheters twice daily until the second postoperative day. Pain intensity was assessed using a 0-10 numerical rating scale at rest and during movement, before and after each block.
  
  
  RESULTS
  Numerical pain ratings at rest and during movement decreased after each block, and good analgesia was obtained. No complications such as nausea, vomiting or infection were observed in the postoperative period.
  
  
  CONCLUSIONS
  These findings suggest that repeated bilateral subcostal TAP blocks with 0.2% lidocaine performed via 18-gauge intravenous catheters provide good postoperative analgesia after abdominal aortic aneurysm resection.
authors.forename: Goh
authors.initials: G
authors.lastname: Yamamoto
authors.forename: Tatsunori
authors.initials: T
authors.lastname: Watanabe
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujiwara
authors.forename: Takashi
authors.initials: T
authors.lastname: Mochida
authors.forename: Ippei
authors.initials: I
authors.lastname: Watanabe
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Kohno
mesh_terms: D000009:Abdominal Muscles / Q000294:innervation*; D000368:Aged; D000698:Analgesia / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D004837:Epinephrine / Q000008:administration & dosage; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000188:drug therapy*; D011182:Postoperative Care; D016896:Treatment Outcome; D062666:Vascular Access Devices
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine; D004837:Epinephrine