Ultrasound-guided subcostal and mid-axillary transversus abdominis plane block: A cadaveric study of the spread of injectate

Takeshi Murouchi, Masanori Yamauchi, Eri Gi, Yukimasa Takada, Aki Mizuguchi, Michiaki Yamakage, Mineko Fujimiya

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)


Background : Mid-axillary transversus abdominis plane block (TAP-B) and subcostal TAP-B have become well-known blocks to provide considerable analgesia for abdominal surgery. However, proper approach and adequate volume of injectate have not still been clarified. In this study a combination of mid-axillary TAP-B and subcostal TAP-B was performed in cadavers to establish the spread of injectate and segmental nerve involvement. Methods : Ultrasound-guided dye injections (10 ml each) into the TAP were performed with mid-axillary and subcostal approaches. Injections were performed for hemiabdominal walls of 4 Thiel's embalmed human cadavers. Dye spread and nerve involvement were evaluated by dissection 10 min after the injections. Results : All 7 hemiabdominal walls were successfully injected and dissected after 1 pilot study. Thoracic nerves (T7-12) and the first lumbar nerve (L1) were found. Segmental nerves T7 (14%), T8-11 (100%), T12(71%), and L1(43%)were involved. Conclusions : This study demonstrated that the combination of ultrasound-guided mid-axillary TAP-B and subcostal TAP-B involve T8-L1 nerves. This technique can be used not only in lower abdominal surgery but also in upper abdominal surgery.

Original languageEnglish
Pages (from-to)60-63
Number of pages4
JournalJapanese Journal of Anesthesiology
Issue number1
Publication statusPublished - 2013 Jan 1
Externally publishedYes


  • Thiel's embalming method
  • Transversus abdominis plane block
  • Ultrasound-guide

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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