Ultrasound-Guided Rectus Sheath Block as the Single Anaesthetic Technique for Umbilical Hernia Repair: A Report of 3 Cases.

In this study, we report 3 cases of ultrasound-guided rectus sheath block used for anaesthetic management of simple periumbilical surgery. We selected 3 patients based on the American Society of Anaesthesiology I-II and defect sizes known to be smaller than 4 cm without peritoneal involvement. We applied a rectus sheath block with 10 mL of 0.5% bupivacaine and 5 mL of 2% lidocaine bilaterally deposited in the space between rectus abdominis and posterior rectus sheath under real-time ultrasonography. Two of our patients tolerated surgery well with minimal sedoanalgesia; however, one of our patients needed dissociative anaesthesia to be compatible because the surgeon found out that the defect was bigger and adjacent to the peritoneum. Rectus sheath block is an underused technique that has the potential to be used as a sole anaesthetic technique in selected cases. So it would be wise to improve and consider rectus sheath block as a valuable tool when there is no better.