Infiltration Technique Descriptions
Ostomy Reversal Infiltration Technique
Insert the needle angled up to 30 degrees at 90-degree intervals around the stoma. Using a fanning technique, infiltrate 2-4 cc local analgesic 2-3 cm beyond the dermal edge (see Figure 4). Repeat for each quadrant.
Dermal wheals should be noted once infiltration has been performed.
2) Deep tissue infiltration:
Under direct visualization, insert the needle at a 30-degree angle along the plane and through the anterior abdominal fascia and subfascia. Needle placement should be deep inside the wound at the level of the abdominal wall fascia and muscle. The goal is to infiltrate lateral to the fascial sutures. Needle should be advanced at a slight angle toward the preperitoneal space. Using a fanning technique and confirming no blood with aspiration, infiltrate 2-4 cc local analgesic 2-3 cm beyond the fascial edge while withdrawing the needle. Under direct visualization, pay special attention to placing local analgesic deep to the anterior abdominal fascia/into the subfascial plane.
Repeat for each quadrant. TOTAL: 20-30 cc
Anterior abdominal wall muscle and fascia
10-15 cc
Infiltration Target
1) Infiltration of dermis and subcutaneous tissue at incision:
Cutaneous and myofascial nerves
10-15 cc
Local Analgesic Volume
6
