Transversus abdominis plane block as the primary anesthetic for laparotomy

Elderly patients undergoing emergency intra-abdominal surgery are at high risk for morbidity and mortality. The risks and side-effects associated with intubation and mechanical ventilation or neuraxial anesthesia must be balanced against the need to maintain hemodynamic stability while maximizing pain control. Providing anesthesia and analgesia without either of these techniques can be a difficult prospect. We present three cases of ultrasound guided transversus abdominis plane (TAP) block as the primary anesthetic for laparotomy in elderly patients with multiple comorbidities. We have demonstrated the efficacy of and recommend the use of TAP blocks as the primary surgical anesthetic in a selected group of patients undergoing laparotomy.