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- W2891912418 abstract "I would like to compliment Staker et al. on their concept of combining ilio-inguinal nerve block with transversus abdominis plane (TAP) block into one procedure, as a component of multi-modal analgesia for elective caesarean section 1. As discussed in the article, TAP block analgesia of the lower abdomen is unreliable and addition of ilio-inguinal block improves this. I would like to invite the authors to comment on several questions I have about their work. The part of Fig. 3 representing the course of the ilio-inguinal and iliohypogastric nerves is anatomically incorrect in about 90% of cases 2. Figure 3 shows the ilio-inguinal nerve penetrating the transversus abdominis muscle/fascia in the posterolateral aspect of the abdominal wall and then travelling through the TAP until it pierces the internal oblique muscle at the anterolateral abdominal wall. If this was accurate, then TAP block would reliably block the ilio-inguinal nerve and there would be no need for I-TAP. Jamison et al. found that the ilio-inguinal nerve travels ventrally to the transversus abdominis muscle and penetrates the muscle (entering the TAP) at the mid-point between the iliac crest and the anterior superior iliac spine in more than 60% of their study sample 2, which is probably why TAP block coverage of ilio-inguinal nerve is variable and why the I-TAP block may have better outcomes. Could the authors provide more information about whether the caesarean sections were performed via either a Pfannenstiel or a vertical infra-umbilical incision? Although a Pfannenstiel incision is made within the dermatomal area covered by the ilio-inguinal nerves, and so amenable to bilateral ilio-inguinal nerve block analgesia only 3, 4, the I-TAP block may only be necessary if a vertical infra-umbilical incision is used." @default.
- W2891912418 created "2018-09-27" @default.
- W2891912418 creator A5002246199 @default.
- W2891912418 date "2018-09-14" @default.
- W2891912418 modified "2023-09-26" @default.
- W2891912418 title "Ilio‐inguinal‐transversus abdominis plane (I‐ TAP ) nerve block for elective caesarean section" @default.
- W2891912418 cites W2015865219 @default.
- W2891912418 cites W2792687280 @default.
- W2891912418 doi "https://doi.org/10.1111/anae.14436" @default.
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