Plane regional blocks

   The paradigm of current anesthesiological provision includes multimodality of anesthesia, one of the main components of which is the interruption of the transmission of an afferent pain impulse at the transmission stage. Regional peripheral blocks successfully cope with this task. Blocks of peripheral nerves passing through the flat intermuscular and interfacial spaces have recently become increasingly used as a component of surgical and postoperative anesthesia. This is explained by the widespread introduction of ultrasound navigation during anesthesiological and resuscitation manipulations, which provides good visualization of anatomical structures, the ability to control the movement of the needle, positioning its distal end and control the spread of local anesthetic. The most frequently performed are such planar blocks as: transversely planar block in the anterior abdominal wall, block of the thoracic nerves, block in the plane of the muscles straightening the back, block of the vagina of the rectus abdominis muscle, paravertebral block. All these techniques are united by the superficial location of anatomical structures and their good ultrasound imaging, the absence of nearby large vessels and nerve trunks, which minimizes unintentional injury of vessels and nerves, the use of low doses of local anesthetics, which minimizes the risk of systemic toxicity, as well as minimal effects on hemodynamics, a good and predictable analgesic effect. This article discusses the anatomy, indications, and techniques of the six most frequently performed planar blocks, which are able to provide effective surgical and postoperative anesthesia, early activation, patient comfort, and shorter hospitalization times. The popularization of these types of planar blocks will be facilitated by informing anesthesiologists about the technical features of their implementation and the advantages they provide.

   Aim. To summarize and present up-to-date information on the most frequently performed and most effective regional peripheral planar blocks.

   Materials and methods. When writing the article, the literature on regional peripheral planar blocks was analyzed from the open electronic scientific databases PubMed, the national electronic medical library of the USA and the databases of the Russian scientific electronic library Elibrary and Cyberleninka.

   Conclusion. Sonoscopically well-visualized anatomical landmarks, the absence of closely located large vascular and nerve formations, a good prolonged analgesic effect even with a single injection of a local anesthetic, the possibility of prolonged anesthesia using catheter technologies during regional planar blocks creates conditions for safe, opioid-free and technically easy to perform postoperative anesthesia, which together contributes to an increasingly widespread use these types of blocks.

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