Transmedian overlap of sensory distribution is a possible cause of unilateral interfascial plane block failure Article Swipe
Amarjeet Kumar
,
Chandni Sinha
,
Kunal Singh
,
Ajeet Kumar
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.4103/ija.ija_847_23
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.4103/ija.ija_847_23
Dear Editor, Cutaneous innervation with clear midline demarcation might not exist for all patients. Several studies have reported variability of peripheral nerve dermatomal distribution with a transmedian overlap of sensory nerve distribution.[1,2] This is due to the peripheral nerve crossing the midline. The variability of peripheral nerve distribution occurs due to anatomical evidence to indicate that the cutaneous nerve crosses the midline or connects with the same nerve on the contralateral side and clinical findings suggestive of the midline crossover. In a study done by Barnett et al., six out of 55 individuals showed perineural spread of the tumour from the trigeminal nerve to its contralateral nerve.[3] The authors reported that four of these patients would have benefited from radiotherapy on the other side. This is indicative of transmedian communications. Four of these patients would have benefited from midline-extended radiotherapy, according to the authors. These findings can have various clinical implications in regional anaesthesia practice.[1,2] A clear-cut demarcated midline sensory loss in all may not be observed. Bilateral sensory blockade may be required for unilateral surgical incision extending up to the midline. Interfascial plane blocks are commonly used to provide sensory analgesia during abdominal surgeries. These include transversus abdominis plane block (TAP block), rectus sheath block, subcostal TAP block, etc. Unilateral injection might not provide complete sensory analgesia medially up to the linea alba because of the midline crossover of the nerves. It may require blockade of the contralateral side to provide complete analgesia.[4] To date, the clinical importance of transmedian sensory overlap has not been discussed in anaesthesia practice. Hence, according to us, a bilateral truncal block would be required for unilateral incisions extending to midline or near midline for adequate pain relief in surgical patients. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
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- Type
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- Language
- en
- Landing Page
- https://doi.org/10.4103/ija.ija_847_23
- OA Status
- diamond
- Cited By
- 1
- References
- 2
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- OpenAlex ID
- https://openalex.org/W4389818335
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https://openalex.org/W4389818335Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.4103/ija.ija_847_23Digital Object Identifier
- Title
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Transmedian overlap of sensory distribution is a possible cause of unilateral interfascial plane block failureWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2023Year of publication
- Publication date
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2023-12-01Full publication date if available
- Authors
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Amarjeet Kumar, Chandni Sinha, Kunal Singh, Ajeet KumarList of authors in order
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https://doi.org/10.4103/ija.ija_847_23Publisher landing page
- Open access
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YesWhether a free full text is available
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diamondOpen access status per OpenAlex
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https://doi.org/10.4103/ija.ija_847_23Direct OA link when available
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Block (permutation group theory), Plane (geometry), Sensory system, Distribution (mathematics), Geology, Geometry, Computer science, Mathematics, Psychology, Neuroscience, Mathematical analysisTop concepts (fields/topics) attached by OpenAlex
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1Total citation count in OpenAlex
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2025: 1Per-year citation counts (last 5 years)
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10Other works algorithmically related by OpenAlex
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| primary_location.raw_source_name | Indian Journal of Anaesthesia |
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| publication_date | 2023-12-01 |
| publication_year | 2023 |
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