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Soliman LM et al. – The “transversus abdominus plane” (TAP) block is used to produce a dermatomal sensory block of the lower six thoracic and upper lumbar abdominal afferents. It was shown to be effective in providing postoperative analgesia after various lower abdominal procedures, mainly radical prostatectomy, large bowel resections, and gynecologic procedures as well as cesarean sections. The recent introduction of ultrasound (US) to different regional anesthesia procedures allows more accurate and safer performance of peripheral nerve blocks. With US imaging, the muscle layers are visible from the rectus medially through the aponeurotic area at the edge of the rectus to the three distinct layers of external, internal oblique, and transversus abdominus in the lateral abdominal wall. Installation of local anesthetics in this plane anesthetizes the anterior abdominal wall on this side. This block can be used as a diagnostic tool or as a therapeutic modality via a continuous indwelling catheter for postoperative lower abdominal pain or chronic pain syndromes arising from the anterior abdominal wall.

Exclusive Author Commentary
Loran Mounir Soliman, 09/24/09

The TAP block is fairly safe and easy to perform block with multiple diagnostic and theraputic potentials that need to be explored. The key is to apply the appropriate block for an appropriate indication.

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