HOW I DO IT

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How I Do It: The pudendal nerve block for pediatric ambulatory urologic surgery
Okoro Chinonyerem, Cannon Shannon, Low Daniel, Lendvay S. Thomas, MD Department of Urology, University of Washington Medical Center, Seattle, WA

Regional analgesia is an important adjunct for perioperative pain management in the setting of pediatric penile surgeries. Caudal epidural analgesia (CEA) is the most common analgesic technique performed, but it has limitations and associated morbidity. The pudendal nerve block (PNB) is an effective alternative to CEA with a lower risk profile; in prior examination of the approach, PNB has been demonstrated to have similar postoperative pain control outcomes. We describe our technique and highlight observations made as we have transitioned from CEA to PNB for many patients.

Keywords: pudendal nerve block, regional anesthesia, pediatric urology, pain management,
Apr 2021 (Vol. 28, Issue 2 , Page 10648)
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How I do it: Surgically inserted transversus abdominis plane (TAP) catheters for flank incisions
Khurana Jaasmit, Ip Vivian, Todd Gerald, Sondekoppam V. Rakesh, MD Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada

Pain control following major abdominal surgery remains a significant barrier to patient comfort. Although thoracic epidurals have been used to provide analgesia for these surgeries, the transversus abdominis plane (TAP) block is gaining popularity. The TAP catheter insertion method has transformed over the past two decades from a blinded technique to one conducted primarily under ultrasound guidance by anesthesiologists. Recently, however, interest has increased on the potential for direct surgical insertion of catheters into the TAP plane following flank incisions due to anatomical considerations. Proposed advantages include a reduction in operating time, requirement of minimal expertise and increased accuracy of catheter placement. In this report, we describe the rationale and the technique of surgical insertion of TAP catheters following open nephrectomies as performed by urologists at our institution.

Keywords: transversus abdominis plane block, nerve block, open nephrectomy,
Dec 2018 (Vol. 25, Issue 6 , Page 9623)
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