Transversus Abdominis Plane Block: How Safe is it?

Jankovic, Zorica; Ahmad, Niaz; Ravishankar, N.; Archer, Frances

doi:10.1213/ane.0b013e3181853619

Cited by 106 publications

(67 citation statements)

References 6 publications

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“…As for the other peripheral nerve blocks, these complications include nerve injury, injection site bruising, infection and allergic reaction. Jankovic et al observed TAP catheter entrance in the peritoneal cavity without any consequences [35] . Two liver lacerations have also been reported [36,37] .…”

Section: Discussionmentioning

confidence: 99%

Peritoneal Dialysis Catheter Placement Using an Ultrasound-Guided Transversus Abdominis Plane Block

Markić¹,

Vujičić²,

Ivanovski³

et al. 2015

Blood Purif

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Background: Peritoneal dialysis (PD) catheter placement is usually performed using general or local anesthesia. We present our PD catheter placement experience using an ultrasound-guided transversus abdominis plane (TAP) block, which is a regional anesthesia technique. Methods: In this study, we analyzed 33 patients from our center with ESRD who underwent PD catheter placement using a TAP block between June 2011 and April 2014. Results: The TAP block was successful for 29/33 (87.9%) patients. Four patients (12.1%) had pain at the incision site and required general anesthesia. There were no anesthesia-, surgery- or catheter-related complications. Conclusion: ESRD patients have a substantial number of comorbidities that can be negatively influenced by general anesthesia. Because regional anesthesia has no systemic effect, this procedure could be recommended for this group of patients. A TAP block is an effective, safe method and can be used as the principal anesthesia technique for PD catheter placement.

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Section: Discussionmentioning

confidence: 99%

Peritoneal Dialysis Catheter Placement Using an Ultrasound-Guided Transversus Abdominis Plane Block

Markić¹,

Vujičić²,

Ivanovski³

et al. 2015

Blood Purif

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“…16,17 McDermott et al 18 reported that that the needle tip and local anesthetic spread were in the correct plane only in 17 of 72 injections (23%) in 36 patients. In the remaining 55 patients, the needle tip was located in the subcutaneous tissue in 1 patient, the external oblique muscle in 1 patient, between the external and internal oblique muscles in 5 patients, the internal oblique muscle in 26 patients, the transversus abdominis muscle in 9 patients, and the peritoneum in 13 patients.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Transversus Abdominis Plane Block and Rectus Sheath Block in Laparoscopic Inguinal Hernia Surgery

Takebayashi

Matsumura

Kawai

et al. 2015

International Surgery

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We aimed to assess the efficacy of transversus abdominis plane (TAP) block and rectus sheath (RS) block in patients undergoing laparoscopic inguinal hernia surgery. Few studies have addressed the efficacy and safety associated with TAP block and RS block for laparoscopic surgery. Thirty-two patients underwent laparoscopic inguinal hernia surgery, either with TAP and RS block (Block þ group, n ¼ 18) or without peripheral nerve block (Block À group, n ¼ 14). Preoperatively, TAP and RS block were performed through ultrasound guidance. We evaluated postoperative pain control and patient outcomes. The mean postoperative hospital stays were 1.56 days (Blockþ group) and 2.07 days (Block À group; range, 1-3 days in both groups; P ¼ 0.0038). A total of 11 patients and 1 patient underwent day surgery in the Block þ and Block À groups, respectively (P ¼ 0.0012). Good postoperative pain control was more commonly observed in the Block þ group than in the Block À group (P ¼ 0.011). TAP and RS block was effective in reducing postoperative pain and was associated with a fast recovery in patients undergoing laparoscopic inguinal hernia surgery.

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“…There is an increased use of ultrasound technology in many areas of regional anaesthesia, hence the rationale for this current anatomical study. Ultrasound-guided TAP block could be considered relatively non-invasive (injecting local anaesthetic into an inter-muscular plane) but case reports have indicated that visceral injury can occur with both ultrasound and landmark guided TAP blockade [13,14]. We recommend the technique of maintaining the needle in the plane of the ultrasound as this may reduce the risk of needle misplacement and visceral injury.…”

Section: Discussionmentioning

confidence: 99%

Spread of injectate after ultrasound‐guided subcostal transversus abdominis plane block: a cadaveric study

Barrington¹,

et al. 2009

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SummaryUltrasound-guided transversus abdominis plane (TAP) block can be performed using a subcostal technique. This technique was simulated using dye injection in cadavers in order to determine segmental nerve involvement and spread of injectate using either single or multiple-injection techniques. Dye most commonly spread to affect T9 and T10 nerves with the single injection technique and T9, T10 and T11 with multiple injections. The median (IQR [range]) spread of dye was 60 (36-63 [32-78]) cm 2 using the single-injection technique and 90 (85-96 [72-136]) cm 2 , in the multiple-injection technique, and this difference was statistically significant (p = 0.003). These results indicate that ultrasound-guided subcostal TAP block will involve nerve roots T9, T10 and T11 and that a multiple-injection technique may block more segmental nerves and increase spread of injectate. The transversus abdominis plane (TAP) block is a regional anaesthesia technique where local anaesthetic is injected into the neurovascular plane between the transversus abdominis and internal oblique muscles. The ventral rami of the segmental thoracolumbar nerves course through the TAP before innervating the anterolateral abdominal wall. The TAP block has been shown to provide postoperative analgesia following abdominal surgery [1][2][3]. These studies have utilised a landmark technique where the injection point into the TAP is through the lumbar triangle in the lateral abdominal wall [4,5]. The TAP block can also be performed with ultrasound imaging to guide injection of local anaesthetic into the neurovascular plane [6][7][8][9]. Real-time imaging of the needle trajectory and injectate spread may improve both safety and block effectiveness. The goal of the TAP block is to anaesthetise several segmental nerves, and recently, we described the extent of nerve involvement using a dye injection study in a cadaver model that simulated an ultrasound-guided TAP block. The probe was placed on the anterolateral abdominal wall between the iliac crest and the costal margin and the needle advanced from an anterior and medial location in a posterolateral direction so that the needle entry point into the TAP was relatively posterior. Using that approach, thoracolumbar nerves, T11, T12 and L1 were the nerves most commonly affected with dye [10].An alternative ultrasound-guided technique is the subcostal TAP block where the probe is placed immediately inferior to the costal margin on the anterior abdominal wall, and an injection made at this location [11]. As a clinical technique, the subcostal ultrasoundguided TAP block may have a different pattern and extent of segmental nerve involvement compared to the posterior technique; hence the primary objective of this anatomical study was to determine the pattern and extent of injectate spread, as measured by segmental nerve involvement with dye and area of dye spread following a simulated ultrasound-guided subcostal TAP block in cadavers. Ultrasound-guided TAP block can be performed using a single-injection or a mul...

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Transversus Abdominis Plane Block: How Safe is it?

Cited by 106 publications

References 6 publications

Peritoneal Dialysis Catheter Placement Using an Ultrasound-Guided Transversus Abdominis Plane Block

Peritoneal Dialysis Catheter Placement Using an Ultrasound-Guided Transversus Abdominis Plane Block

Efficacy of Transversus Abdominis Plane Block and Rectus Sheath Block in Laparoscopic Inguinal Hernia Surgery

Spread of injectate after ultrasound‐guided subcostal transversus abdominis plane block: a cadaveric study

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