title: Oblique sub-costal transversus abdominis plane (TAP) catheters: an alternative to epidural analgesia after upper abdominal surgery.
abstract: The authors present three cases where catheters placed in the oblique sub-costal transversus abdominis plane provided prolonged analgesia after upper abdominal surgery. Patient 1 was admitted with severe sepsis following major hepatobiliary surgery. Bilateral catheters facilitated weaning from mechanical ventilation and provided adequate analgesia for 4 days. Patient 2 underwent emergency laparotomy for intestinal obstruction having refused consent for epidural analgesia. The transversus abdominis plane catheters provided a significant opioid sparing effect. A unilateral catheter offered rescue analgesia in patient 3 when the epidural catheter was displaced. We put forward a case for oblique sub-costal transversus abdominis plane catheters as an alternative to epidural analgesia after upper abdominal surgery.
authors.affiliation: Department of Anaesthesia and Critical Care Medicine, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK. nirajgopinath@yahoo.co.uk
authors.forename: G
authors.initials: G
authors.lastname: Niraj
authors.forename: A
authors.initials: A
authors.lastname: Kelkar
authors.forename: A J
authors.initials: AJ
authors.lastname: Fox
mesh_terms: D000005:Abdomen / Q000601:surgery*; D034861:Abdominal Wall; D000368:Aged; D000369:Aged, 80 and over; D015360:Analgesia, Epidural; D000779:Anesthetics, Local / Q000008:administration & dosage; D000075202:Contraindications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000628:therapy*
chemical_list: D000779:Anesthetics, Local