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TRANSVERSUS ABDOMINIS PLANE BLOCK IN SOFT-FIX EMBALMED CADAVERS: THE TRAINING POTENTIAL AND INJECTATE SPREAD
ESRA Academy. Chalmers J. Sep 8, 2016; 138331; 0165 Topic: Trunk Blocks
John Chalmers
John Chalmers

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Abstract
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Background and Aims:

Previous studies have confirmed the ability to perform accurate ultrasound guided transversus abdominis plane (TAP) blocks in frozen (unembalmed) cadavers, with injectate spread similar to that seen in live patients. However, there is little evidence on whether TAP blocks can be reliably performed in Genelyn® (soft-embalmed) cadavers. These are more cost-effective than frozen cadavers and have more flexible tissues than traditional formalin embalmed cadavers. Therefore, they may offer advantages in TAP block simulation.

Our primary aim was to assess the feasibility of performing TAP blocks in Genelyn® cadavers in a medical education setting.

A secondary aim was to assess the spread of injectate within the TAP, to compare with other cadaveric and clinical studies.

Methods:

Six Genelyn® hemi-abdomens were injected. An experienced consultant regional anaesthetist used a Sonosite® ultrasound machine and Pajunk® SonoPlex® needles to inject 20 mls of indocyanine green dye into the TAP. Dissection was performed to assess injectate spread.

Results:

Two injections were completely successful (dye solely in the TAP), two were partially successful, and two were unsuccessful. A number of challenges with block performance were identified: the ultrasound image was challenging to interpret, needle manipulation was difficult, tactile appreciation of fascial planes was lacking, and visualisation of injectate spread was poor.

Dye spread to surround the T9 – T12 thoracoabdominal nerves in successful injections.

Conclusions:

Our results suggest Genelyn® embalmed cadavers would not be a useful tool for TAP block simulation. Further research is warranted. The spread of dye within the TAP echoed the spread found in other studies.

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