4 – Scanning technique

Place the patient supine

Select a high-frequency linear probe or a curved array probe and place it in the axial plane just proximal to the iliac crest

Identify the three layers of abdominal muscles and slide the probe posterior until you can visualize the posterior aponeurotic extension of the transverse abdominis muscle connecting to the quadratus lumborum muscle (see next page)

Insert the needle from the anterior end of the probe with in-plane technique and advance the needle tip to the fascial plane between the transverse abdominis muscle and the transversalis fascia just anterior to the transverse abdominis aponeurosis

Inject 10 mL of local anaesthetic in this location and it will spread across the aponeurosis and anaesthetize the subcostal and iliohypogastric nerves before the lateral cutaneous branches branch off