The rectus sheath block is used for postoperative analgesia for midline abdominal incisions. A bilateral block results in analgesia of the anteromedial abdominal wall and periumbilical area (spinal dermatomes 9, 10, and 11). 

Here are 4 steps to successfully perform a rectus sheath block

1. Place the transducer in a transverse orientation above the umbilicus, 1 cm lateral to the midline.
2. Identify the rectus abdominis muscle and posterior rectus sheath.
3. Insert the needle in-plane through the rectus abdominis muscle until the tip reaches the space between the muscle and posterior rectus sheath, and inject 10-15 mL of local anesthetic.
4. Repeat on the contralateral side.

This block should be performed bilaterally!

Watch the video below to get a better picture of the process and see how the NYSORA Nerve Blocks App brings these instructions to life: 

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