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Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy

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Transversus abdominis plane block.

Olivia Finnerty¹, John G McDonnell

¹Department of Anesthesia, Clinical Sciences Institute, National University of Ireland, Galway, Ireland.

Current Opinion in Anaesthesiology

|August 24, 2012

Summary

This summary is machine-generated.

The transversus abdominis plane (TAP) block is an effective analgesic, but optimal approaches remain debated. Ultrasound guidance has raised new questions, necessitating further research comparing TAP/RAFI blocks with epidural analgesia.

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Area of Science:

Anesthesiology
Regional Anesthesia
Pain Management

Background:

The transversus abdominis plane (TAP) block has seen extensive research with 146 publications since its inception.
Clinical application of the TAP block is ongoing, yet controversies persist regarding optimal techniques.
The advent of ultrasound has complicated, rather than clarified, the understanding and application of the TAP block.

Purpose of the Study:

To review the current understanding of the transversus abdominis plane (TAP) block and its mechanisms of action.
To address ongoing controversies regarding the best approaches for performing the TAP block.
To evaluate if previous reviews were premature given the evolving nature of the TAP block.

Main Methods:

Review of existing peer-reviewed literature on the transversus abdominis plane (TAP) block.
Analysis of recent research concerning the spread and effects of local anesthetics in TAP blocks.
Evaluation of the impact of ultrasound guidance on TAP block techniques and outcomes.

Main Results:

The TAP block is understood to be a multifaceted technique with both localized and distal effects from local anesthetic spread.
Needle tip placement significantly influences the characteristics and efficacy of the TAP block.
Anterior approaches, often guided by ultrasound, may function more as regional abdominal field infiltration (RAFI) blocks.

Conclusions:

The TAP block, in its various forms including RAFI, is a valuable tool for analgesia.
Further randomized controlled trials are necessary to compare TAP/RAFI blocks directly with epidural analgesia.
Clarification of the optimal approach for the TAP block is still needed.