Ultrasound Blocks for the Anterior Abdominal Wall

3. Transverse Abdominal Plexus Block | 35
3. Transverse Abdominal Plexus Block
Zhirajr Mokini
The block of transverse abdominal plexus (TAPB) provides
effective analgesia when used as a part of multimodal analgesic
strategies for abdominal surgery and in chronic pain. From the
first description, several clinical trials have evaluated the TAPB
for postoperative analgesia in a variety of procedures (Rafi 2001)
Conceptually the TAPB is a compartmental block because the
local anesthetic is deposited into the fascial plane between the
internal oblique muscle and the transverse abdominal muscle.
Cadaveric and radiological studies have demonstrated the
deposition of the local anesthetic in the TAM plane (McDonnell
2007).
Unlike the rectus sheath block (RSB), which targets only the
midline, the TAPB targets the entire anterior-lateral abdominal
wall (Rozen 2008). The extent of the block will depend on the
puncture site and the volume of local anesthetic. The typical
volume used for the TAPB is 20 to 30 ml each side. The maximum
block extent is observed after 30 to 60 minutes and residual
block may persist after 24 hours (Lee 2008). The block can be
achieved both blindly and with the use of ultrasounds. Technical
aspects of the TAPB and other blocks are showed in Table 6.1.