Rectus sheath catheters for continuous analgesia after upper abdominal surgery

Area of Science:

• Anesthesiology
• Surgical Anatomy
• Pain Management

Background:

• Segmental nerves T6-T11 innervate the rectus abdominis muscle and skin.
• Arcuate lines create compartments within the rectus abdominis muscle.
• Posterior fascial defects exist due to arcuate line deficiency.

Purpose of the Study:

• To describe a continuous analgesic block technique targeting the rectus abdominis muscle.
• To evaluate the efficacy of a posterior rectus sheath catheter placement.
• To present a viable alternative to epidural analgesia.

Main Methods:

• Utilized the anatomical deficiency in the posterior rectus sheath.
• Tunnelled a catheter into the posterior rectus sheath.
• Administered analgesic solution to fill the compartmental space.

Main Results:

• Achieved effective continuous analgesic block.
• The procedure is technically simple.
• Demonstrated several advantages compared to other techniques.

Conclusions:

• Posterior rectus sheath catheterization is an effective method for continuous abdominal analgesia.
• The technique is a viable alternative to epidural analgesia.
• Adequate volume is crucial for successful compartmental blockade.