On the prospects of using myofascial blocks in obstetric and gynecological practice

The increase in the number of minimally invasive surgical interventions and the introduction of the concept of Enhanced Recovery After Surgery necessitate a search for alternative safe anesthesia procedures. Active studies have recently been underway to use new regional anesthesia procedures based on myofascial blocks that can become an alternative to epidural blockade. These blocks include a transversus abdominal plane (TAP) block, a quadratus lumborum muscle block (QLB), an erector spinae plane (ESP) block, retrolaminar block (RLB), which are performed using ultrasonic navigation. The benefit of using these blocks is the ease of their implementation, a low risk of complications, the impact on the initial stages of the onset of pain syndrome (transduction and transmission); in the absence of a motor block; the possibility of affecting the visceral component of pain, the reduction of sympathetic influences, which provides a stress-limiting effect and promotes early recovery after surgery. The review considers the use of myofascial blocks, with an emphasis on the blocks of the posterior abdominal wall, in the perioperative period during obstetric and gynecological surgical interventions. Conclusion. The above determines the need for a closer study of the anatomical points of application, the mechanisms of action, as well as for evaluation of the clinical effectiveness of these procedures.

QLB, RLB, myofascial blocks, TAP block, QLB, ESP block, RLB, regional anesthesia