Blocs abdominaux chez l'enfant : blocs paravertébral et intercostal

The abdominal wall is supplied by the lower six thoracic and upper two lumbar sensory nerves. The extent of nerves blockade to provide analgesia for abdominal surgeries is a real issue. Low thoracic epidural remains the “gold standard”. Unfortunately, epidural-based analgesia is not always possible or appropriate. Unlike central neuraxial blockade, the main drawback of trunk blocks, appropriate for abdominal surgical procedures where parietal pain is the significant component of postoperative pain, is that a bilateral block is commonly required and continuous local anesthetic infusions with catheter on each side are not that easy… Improvements in anatomical knowledge and evolution of technical approaches (ultrasonography) have promoted a variety of analgesic techniques used in current clinical practice. The practical aspects of non-central neuraxial blocks of the abdomen including thoracic and upper lumbar paravertebral, intercostal, fascia transversalis plane, transversus abdominis plane, rectus sheath and para-ombilical and iliohypogastric-ilio-inguinal blocks are described in this review.