Blockade of thoracoabdominal intercostal nerves (T6-T12) as they travels through TAP (and diverges into anterior and lateral branches) providing analgesia to overlying skin and muscular structures of abdomen
Provides temporary unilateral analgesia ranging from 6-18 hours to overlying skin and muscular structures of abdominal wall depending on site of injection
Subcostal TAP block renders upper abdominal coverage of T7-T9 dermatomes
Traditional TAP block renders analgesia to T10-T12 dermatomes
Longer duration of analgesia can be achieved by placing catheter
Can be performed with patient awake or while under general anesthesia
Fascial plane block; therefore, block is more successful with higher volume (and lower concentration) of local anesthetic
PREPROCEDURE
Indications
Contraindications
Getting Started
PROCEDURE
Patient Position/Location
Equipment Preparation
Procedure Steps
Findings and Reporting
Alternative Procedures/Therapies
POST PROCEDURE
Expected Outcome
Things to Do
Things to Avoid
OUTCOMES
Problems
Complications
Selected References
Theodoraki K et al: The effect of transversus abdominis plane block on acute and chronic pain after inguinal hernia repair. A randomized controlled trial. Int J Surg. 63:63-70, 2019
Gnanasekar N et al: Comparative evaluation of ropivacaine and ropivacaine with dexamethasone in transverse abdominis plane block for lower abdominal surgeries: a prospective, randomized, double-blinded study. Anesth Essays Res. 12(4):937-42, 2018
Sanderson BJ et al: Transversus abdominis plane catheters for analgesia following abdominal surgery in adults. Reg Anesth Pain Med. 43(1):5-13, 2018
Chin KJ et al: Essentials of our current understanding: abdominal wall blocks. Reg Anesth Pain Med. 42(2):133-83, 2017
Fusco P et al: Transversus abdominis plane block in the management of acute postoperative pain syndrome after caesarean section: a randomized controlled clinical trial. Pain Physician. 19(8):583-91, 2016
Gasanova I et al: Transversus abdominis plane block versus surgical site infiltration for pain management after open total abdominal hysterectomy. Anesth Analg. 121(5):1383-8, 2015
Hutchins J et al: Ultrasound-guided subcostal transversus abdominis plane infiltration with liposomal bupivacaine for patients undergoing robotic-assisted hysterectomy: a retrospective study. Int J Gynecol Cancer. 25(5):937-41, 2015
Murouchi T et al: Chronological changes in ropivacaine concentration and analgesic effects between transversus abdominis plane block and rectus sheath block. Reg Anesth Pain Med. 40(5):568-71, 2015
Abdul Jalil RM et al: Comparing the effectiveness of ropivacaine 0.5% versus ropivacaine 0.2% for transabdominis plane block in providing postoperative analgesia after appendectomy. Acta Anaesthesiol Taiwan. 52(2):49-53, 2014
Almarakbi WA et al: Addition of dexmedetomidine to bupivacaine in transversus abdominis plane block potentiates post-operative pain relief among abdominal hysterectomy patients: a prospective randomized controlled trial. Saudi J Anaesth. 8(2):161-6, 2014
Børglum J et al: TAP block terminology. Anaesthesia. 69(9):1055-6, 2014
Børglum J et al: Transversus abdominis plane block in inguinal hernia repair. Eur J Anaesthesiol. 31(7):391-2, 2014
Calle GA et al: Transversus abdominis plane block after ambulatory total laparoscopic hysterectomy: randomized controlled trial. Acta Obstet Gynecol Scand. 93(4):345-50, 2014
Feierman DE et al: Liposomal bupivacaine infiltration into the transversus abdominis plane for postsurgical analgesia in open abdominal umbilical hernia repair: results from a cohort of 13 patients. J Pain Res. 7:477-82, 2014
Kitayama M et al: Effects of adding epinephrine on the early systemic absorption kinetics of local anesthetics in abdominal truncal blocks. J Anesth. 28(4):631-4, 2014
Restrepo-Garces CE et al: Subcostal transversus abdominis plane phenol injection for abdominal wall cancer pain. Pain Pract. 14(3):278-82, 2014
Abdallah FW et al: Duration of analgesic effectiveness after the posterior and lateral transversus abdominis plane block techniques for transverse lower abdominal incisions: a meta-analysis. Br J Anaesth. 111(5):721-35, 2013
Griffiths JD et al: Symptomatic local anaesthetic toxicity and plasma ropivacaine concentrations after transversus abdominis plane block for caesarean section. Br J Anaesth. 110(6):996-1000, 2013
Sharkey A et al: Role of transversus abdominis plane block after caesarean delivery. Curr Opin Anaesthesiol. 26(3):268-72, 2013
Ammar AS et al: Effect of adding dexamethasone to bupivacaine on transversus abdominis plane block for abdominal hysterectomy: a prospective randomized controlled trial. Saudi J Anaesth. 6(3):229-33, 2012
Bollag L et al: Effect of transversus abdominis plane block with and without clonidine on post-cesarean delivery wound hyperalgesia and pain. Reg Anesth Pain Med. 37(5):508-14, 2012
Børglum J et al: Distribution patterns, dermatomal anesthesia, and ropivacaine serum concentrations after bilateral dual transversus abdominis plane block. Reg Anesth Pain Med. 37(3):294-301, 2012
Corvetto MA et al: Comparison of plasma concentrations of levobupivacaine with and without epinephrine for transversus abdominis plane block. Reg Anesth Pain Med. 37(6):633-7, 2012
Finnerty O et al: Transversus abdominis plane block. Curr Opin Anaesthesiol. 25(5):610-4, 2012
Torup H et al: Potentially toxic concentrations in blood of total ropivacaine after bilateral transversus abdominis plane blocks; a pharmacokinetic study. Eur J Anaesthesiol. 29(5):235-8, 2012
Young MJ et al: Clinical implications of the transversus abdominis plane block in adults. Anesthesiol Res Pract. 2012:731645, 2012
Carney J et al: The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy. Anesth Analg. 107(6):2056-60, 2008
McDonnell JG et al: The analgesic efficacy of transversus abdominis plane block after cesarean delivery: a randomized controlled trial. Anesth Analg. 106(1):186-91, 2008
McDonnell JG et al: Transversus abdominis plane block: a cadaveric and radiological evaluation. Reg Anesth Pain Med. 32(5):399-404, 2007
McDonnell JG et al: The analgesic efficacy of transversus abdominis plane block after abdominal surgery: a prospective randomized controlled trial. Anesth Analg. 104(1):193-7, 2007
Rafi AN: Abdominal field block: a new approach via the lumbar triangle. Anaesthesia. 56(10):1024-6, 2001
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Preprocedure
Procedure
Post Procedure
Outcomes
TERMINOLOGY
Abbreviations
Transversus abdominis plane (TAP)
Rectus abdominis muscle (RAM)
External oblique muscle (EOM)
Internal oblique muscle (IOM)
Transversus abdominis muscle (TAM)
Anterior super iliac spine (ASIS)
Definitions
Blockade of thoracoabdominal intercostal nerves (T6-T12) as they travels through TAP (and diverges into anterior and lateral branches) providing analgesia to overlying skin and muscular structures of abdomen
Provides temporary unilateral analgesia ranging from 6-18 hours to overlying skin and muscular structures of abdominal wall depending on site of injection
Subcostal TAP block renders upper abdominal coverage of T7-T9 dermatomes
Traditional TAP block renders analgesia to T10-T12 dermatomes
Longer duration of analgesia can be achieved by placing catheter
Can be performed with patient awake or while under general anesthesia
Fascial plane block; therefore, block is more successful with higher volume (and lower concentration) of local anesthetic
PREPROCEDURE
Indications
Contraindications
Getting Started
PROCEDURE
Patient Position/Location
Equipment Preparation
Procedure Steps
Findings and Reporting
Alternative Procedures/Therapies
POST PROCEDURE
Expected Outcome
Things to Do
Things to Avoid
OUTCOMES
Problems
Complications
Selected References
Theodoraki K et al: The effect of transversus abdominis plane block on acute and chronic pain after inguinal hernia repair. A randomized controlled trial. Int J Surg. 63:63-70, 2019
Gnanasekar N et al: Comparative evaluation of ropivacaine and ropivacaine with dexamethasone in transverse abdominis plane block for lower abdominal surgeries: a prospective, randomized, double-blinded study. Anesth Essays Res. 12(4):937-42, 2018
Sanderson BJ et al: Transversus abdominis plane catheters for analgesia following abdominal surgery in adults. Reg Anesth Pain Med. 43(1):5-13, 2018
Chin KJ et al: Essentials of our current understanding: abdominal wall blocks. Reg Anesth Pain Med. 42(2):133-83, 2017
Fusco P et al: Transversus abdominis plane block in the management of acute postoperative pain syndrome after caesarean section: a randomized controlled clinical trial. Pain Physician. 19(8):583-91, 2016
Gasanova I et al: Transversus abdominis plane block versus surgical site infiltration for pain management after open total abdominal hysterectomy. Anesth Analg. 121(5):1383-8, 2015
Hutchins J et al: Ultrasound-guided subcostal transversus abdominis plane infiltration with liposomal bupivacaine for patients undergoing robotic-assisted hysterectomy: a retrospective study. Int J Gynecol Cancer. 25(5):937-41, 2015
Murouchi T et al: Chronological changes in ropivacaine concentration and analgesic effects between transversus abdominis plane block and rectus sheath block. Reg Anesth Pain Med. 40(5):568-71, 2015
Abdul Jalil RM et al: Comparing the effectiveness of ropivacaine 0.5% versus ropivacaine 0.2% for transabdominis plane block in providing postoperative analgesia after appendectomy. Acta Anaesthesiol Taiwan. 52(2):49-53, 2014
Almarakbi WA et al: Addition of dexmedetomidine to bupivacaine in transversus abdominis plane block potentiates post-operative pain relief among abdominal hysterectomy patients: a prospective randomized controlled trial. Saudi J Anaesth. 8(2):161-6, 2014
Børglum J et al: TAP block terminology. Anaesthesia. 69(9):1055-6, 2014
Børglum J et al: Transversus abdominis plane block in inguinal hernia repair. Eur J Anaesthesiol. 31(7):391-2, 2014
Calle GA et al: Transversus abdominis plane block after ambulatory total laparoscopic hysterectomy: randomized controlled trial. Acta Obstet Gynecol Scand. 93(4):345-50, 2014
Feierman DE et al: Liposomal bupivacaine infiltration into the transversus abdominis plane for postsurgical analgesia in open abdominal umbilical hernia repair: results from a cohort of 13 patients. J Pain Res. 7:477-82, 2014
Kitayama M et al: Effects of adding epinephrine on the early systemic absorption kinetics of local anesthetics in abdominal truncal blocks. J Anesth. 28(4):631-4, 2014
Restrepo-Garces CE et al: Subcostal transversus abdominis plane phenol injection for abdominal wall cancer pain. Pain Pract. 14(3):278-82, 2014
Abdallah FW et al: Duration of analgesic effectiveness after the posterior and lateral transversus abdominis plane block techniques for transverse lower abdominal incisions: a meta-analysis. Br J Anaesth. 111(5):721-35, 2013
Griffiths JD et al: Symptomatic local anaesthetic toxicity and plasma ropivacaine concentrations after transversus abdominis plane block for caesarean section. Br J Anaesth. 110(6):996-1000, 2013
Sharkey A et al: Role of transversus abdominis plane block after caesarean delivery. Curr Opin Anaesthesiol. 26(3):268-72, 2013
Ammar AS et al: Effect of adding dexamethasone to bupivacaine on transversus abdominis plane block for abdominal hysterectomy: a prospective randomized controlled trial. Saudi J Anaesth. 6(3):229-33, 2012
Bollag L et al: Effect of transversus abdominis plane block with and without clonidine on post-cesarean delivery wound hyperalgesia and pain. Reg Anesth Pain Med. 37(5):508-14, 2012
Børglum J et al: Distribution patterns, dermatomal anesthesia, and ropivacaine serum concentrations after bilateral dual transversus abdominis plane block. Reg Anesth Pain Med. 37(3):294-301, 2012
Corvetto MA et al: Comparison of plasma concentrations of levobupivacaine with and without epinephrine for transversus abdominis plane block. Reg Anesth Pain Med. 37(6):633-7, 2012
Finnerty O et al: Transversus abdominis plane block. Curr Opin Anaesthesiol. 25(5):610-4, 2012
Torup H et al: Potentially toxic concentrations in blood of total ropivacaine after bilateral transversus abdominis plane blocks; a pharmacokinetic study. Eur J Anaesthesiol. 29(5):235-8, 2012
Young MJ et al: Clinical implications of the transversus abdominis plane block in adults. Anesthesiol Res Pract. 2012:731645, 2012
Carney J et al: The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy. Anesth Analg. 107(6):2056-60, 2008
McDonnell JG et al: The analgesic efficacy of transversus abdominis plane block after cesarean delivery: a randomized controlled trial. Anesth Analg. 106(1):186-91, 2008
McDonnell JG et al: Transversus abdominis plane block: a cadaveric and radiological evaluation. Reg Anesth Pain Med. 32(5):399-404, 2007
McDonnell JG et al: The analgesic efficacy of transversus abdominis plane block after abdominal surgery: a prospective randomized controlled trial. Anesth Analg. 104(1):193-7, 2007
Rafi AN: Abdominal field block: a new approach via the lumbar triangle. Anaesthesia. 56(10):1024-6, 2001
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