Indications
- Abdominal wall lacerations or injuries
Contraindications
- Infection overlying injection site
- Allergy to local anesthetic
Equipment
- 15-20cc of local anesthetic of choice diluted with 15-20cc of normal saline
- 20-22G needle (or spinal needle)
- Cleansing solution
- Ultrasound with high-frequency linear transducer
- Ultrasound transducer sterile cover
Preparation
Position
Position the patient supine
Ultrasound
Landmarks
Palpate the bony landmarks including the inferior costal margin and the iliac crest. Position the transducer in the transverse plane between the bony landmarks.
Technique
- In-plane needle visualization
- Enter anterior to transducer with steep angle
- Advance needle to plane between internal oblique and transversus abdominis muscles
- Open the potential space with combined local anesthetic and normal saline