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Brown: Atlas of Regional Anesthesia, 3rd ed., Copyright © 2006 Saunders, An Imprint of Elsevier
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PEARLS

This block is technically easy, and the patient is more comfortable with an appropriate level of sedation. The importance of identifying the transverse process before advancing too deeply must be emphasized. In the absence of an appropriate landmark to limit and guide subsequent anterior advancement, it is possible to enter the abdominal cavity. This block should not be performed in the presence of significant anticoagulation, as it is possible to produce a significant retroperitoneal hematoma. Although this block may be used as a primary anesthetic, it is more commonly used to provide postoperative analgesia.

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