Deep Rectus Sheath (Preperitoneal) Block in Laparoscopic Cholecystectomy: A Case Report

Preperitoneal injection has been considered a complication in the classical rectus sheath block. However, a group of Italian anesthesiologists recently explored the technique of targeting the preperitoneal space (also known as the deep rectus sheath or preperitoneal block) for analgesia in open abdominal surgery. This case report describes a laparoscopically guided rectus sheath and preperitoneal block performed during laparoscopic cholecystectomy. The patient experienced effective pain control without opioids or complications. Ultrasound imaging confirmed anesthetic distribution above and under the deep rectus sheath. While promising, this technique remains experimental, requiring further study to clarify its mechanism and to standardize its application.