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Transversus abdominis plane (TAP) blocks-a review.

J M Findlay¹, S Q Ashraf, P Congahan

¹Department of Oesophagogastric Surgery, Churchill Hospital, Oxford, UK. johnfindlay@doctors.org.uk

The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

|September 15, 2012

Summary

Transversus abdominis plane (TAP) blockade effectively reduces post-operative opioid use and side effects in abdominal surgery. This technique shows promise as an alternative to epidural analgesia, improving patient recovery and hospital discharge.

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Area of Science:

Regional anesthesia
Surgical pain management
Abdominal surgery

Background:

Effective post-operative pain management is crucial for patient outcomes.
Multimodal analgesia and epidural techniques have limitations, including side effects and resource intensity.
There is a need for alternative regional anesthetic techniques to minimize opioid use, especially for minimally invasive abdominal surgery and enhanced recovery programs.

Purpose of the Study:

To evaluate the evidence supporting Transversus abdominis plane (TAP) blockade.
To assess the efficacy of TAP blockade in post-operative pain management.
To explore TAP blockade as an alternative to epidural analgesia.

Main Methods:

A literature search was conducted using PubMed.
Search terms included 'transversus abdominis plane' and 'TAP'.
Applicable studies were identified, excluding case reports and correspondence.

Main Results:

Thirteen studies examined TAP blockade technique and mechanisms.
Fourteen clinical studies (1250 patients) were analyzed.
Seven studies (6 RCTs) showed significant reductions in post-operative morphine requirements (33.3%-73.1%).
Five RCTs reported improved pain scores and reduced opioid side effects.
One PCT indicated earlier return of gastrointestinal function and hospital discharge.

Conclusions:

Transversus abdominis plane (TAP) blockade appears to be an effective adjunct for post-operative analgesia in abdominal surgery.
Its role as an alternative to epidural analgesia requires further investigation.
The technique's utility in enhanced recovery programs is expected to become clearer as its popularity grows.