link
Bookmarks
TAP Block
Rafael Vazquez, MD; Nicole Z. Spence, MD
To access 4,300 diagnoses written by the world's leading experts in radiology, please log in or subscribe.Log inSubscribe

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

                                      1. 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
                                      2. 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
                                      3. Sanderson BJ et al: Transversus abdominis plane catheters for analgesia following abdominal surgery in adults. Reg Anesth Pain Med. 43(1):5-13, 2018
                                      4. Chin KJ et al: Essentials of our current understanding: abdominal wall blocks. Reg Anesth Pain Med. 42(2):133-83, 2017
                                      5. 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
                                      6. 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
                                      7. 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
                                      8. 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
                                      9. 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
                                      10. 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
                                      11. Børglum J et al: TAP block terminology. Anaesthesia. 69(9):1055-6, 2014
                                      12. Børglum J et al: Transversus abdominis plane block in inguinal hernia repair. Eur J Anaesthesiol. 31(7):391-2, 2014
                                      13. 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
                                      14. 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
                                      15. 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
                                      16. Restrepo-Garces CE et al: Subcostal transversus abdominis plane phenol injection for abdominal wall cancer pain. Pain Pract. 14(3):278-82, 2014
                                      17. 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
                                      18. 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
                                      19. Sharkey A et al: Role of transversus abdominis plane block after caesarean delivery. Curr Opin Anaesthesiol. 26(3):268-72, 2013
                                      20. 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
                                      21. 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
                                      22. 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
                                      23. 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
                                      24. Finnerty O et al: Transversus abdominis plane block. Curr Opin Anaesthesiol. 25(5):610-4, 2012
                                      25. 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
                                      26. Young MJ et al: Clinical implications of the transversus abdominis plane block in adults. Anesthesiol Res Pract. 2012:731645, 2012
                                      27. 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
                                      28. 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
                                      29. McDonnell JG et al: Transversus abdominis plane block. Anesth Analg. 105(3):883, 2007
                                      30. McDonnell JG et al: Transversus abdominis plane block: a cadaveric and radiological evaluation. Reg Anesth Pain Med. 32(5):399-404, 2007
                                      31. 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
                                      32. Rafi AN: Abdominal field block: a new approach via the lumbar triangle. Anaesthesia. 56(10):1024-6, 2001
                                      Related Anatomy
                                      Loading...
                                      Related Differential Diagnoses
                                      Loading...
                                      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

                                                                          1. 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
                                                                          2. 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
                                                                          3. Sanderson BJ et al: Transversus abdominis plane catheters for analgesia following abdominal surgery in adults. Reg Anesth Pain Med. 43(1):5-13, 2018
                                                                          4. Chin KJ et al: Essentials of our current understanding: abdominal wall blocks. Reg Anesth Pain Med. 42(2):133-83, 2017
                                                                          5. 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
                                                                          6. 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
                                                                          7. 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
                                                                          8. 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
                                                                          9. 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
                                                                          10. 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
                                                                          11. Børglum J et al: TAP block terminology. Anaesthesia. 69(9):1055-6, 2014
                                                                          12. Børglum J et al: Transversus abdominis plane block in inguinal hernia repair. Eur J Anaesthesiol. 31(7):391-2, 2014
                                                                          13. 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
                                                                          14. 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
                                                                          15. 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
                                                                          16. Restrepo-Garces CE et al: Subcostal transversus abdominis plane phenol injection for abdominal wall cancer pain. Pain Pract. 14(3):278-82, 2014
                                                                          17. 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
                                                                          18. 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
                                                                          19. Sharkey A et al: Role of transversus abdominis plane block after caesarean delivery. Curr Opin Anaesthesiol. 26(3):268-72, 2013
                                                                          20. 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
                                                                          21. 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
                                                                          22. 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
                                                                          23. 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
                                                                          24. Finnerty O et al: Transversus abdominis plane block. Curr Opin Anaesthesiol. 25(5):610-4, 2012
                                                                          25. 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
                                                                          26. Young MJ et al: Clinical implications of the transversus abdominis plane block in adults. Anesthesiol Res Pract. 2012:731645, 2012
                                                                          27. 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
                                                                          28. 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
                                                                          29. McDonnell JG et al: Transversus abdominis plane block. Anesth Analg. 105(3):883, 2007
                                                                          30. McDonnell JG et al: Transversus abdominis plane block: a cadaveric and radiological evaluation. Reg Anesth Pain Med. 32(5):399-404, 2007
                                                                          31. 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
                                                                          32. Rafi AN: Abdominal field block: a new approach via the lumbar triangle. Anaesthesia. 56(10):1024-6, 2001