Performing The Block: Abdominal

Question 1

Performing the TAP block

Lateral approach

Answer 1

• probe is placed above and parrallel to the iliac crest
• Needle is inserted in-plane medial to the probe
• Inject local in the transverse abdominus plane

Question 2

Subcostal TAP block

Answer 2

placed inferior to the costal margin
used for upper abdominal incisions

Question 3

QL1 Block

Lateral

Answer 3

LA is deposited lateral to the QL muscle

Question 4

QL2 Block

Posterior

Answer 4

LA is deposited between the QL and latissimus dorsi

posterior

Question 5

QL3 Block

transmuscular / anterior

Answer 5

LA is deposited between the QL and psoas major

Question 6

What muscles does the QL3 block go through?

Answer 6

the QL

Quadratrus Lumborum

Question 7

Patient positoning for QL1 and QL2?

Answer 7

Supine

Question 8

Patient positioning for QL3?

Answer 8

Lateral

Question 9

What can the QL muscle look like under US?

Answer 9

A flag off a flagpole

Question 10

Rectus sheath block under US

Answer 10

• probe is placed transverse on the abdomen lateral to umbilicus
• needle is advanced (lateral to medial) deep to the rectus abdominus and superficial to the posterior rectus sheath
• ≈10mL of LA injected
• repeat for opposite side

Question 11

Ilioinguinal/Iliohypogastric block under US

Answer 11

Same plane as TAP just lower
probe is placed medial to the anterior-superior iliac spine
angle towards umbilicus
Needles inserted throught the external oblique internal oblique
LA injected between internal oblique and transverse abdominus