title: Evolution of the transversus abdominis plane block and its role in postoperative analgesia.
abstract: Since it was first described by Rafi in 2001, the transversus abdominis plane (TAP) block can be best described as a peripheral nerve block to the anterior abdominal wall (T6 to L1). The TAP block is specifically a local anesthetic injection into the fascial plane superficial to the transversus abdominis muscle and deep to the internal oblique muscle. The TAP block has been a subject of controversy with regard to utility, to indications, and more fundamentally, how best to place the block and its precise mechanism of action. The evolution of thinking with regard to this block, or more correctly family of interrelated blocks, includes knowledge of underlying anatomy, as well as an appreciation of its varied approaches. The TAP block affords excellent analgesia for abdominal procedures. In summary, the TAP block affords effective analgesia with opioid sparing effects, technical simplicity, and long duration of action. Some disadvantages include the need for bilateral block for midline incisions and absence of effectiveness for visceral pain.
authors.affiliation: Department of Anesthesiology, Louisiana State University School of Medicine, New Orleans, LA, USA. Electronic address: jonlissauer@gmail.com.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Lissauer
authors.affiliation: Department of Anesthesiology, Louisiana State University School of Medicine, New Orleans, LA, USA. Electronic address: kmancu@lsuhsc.edu.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Mancuso
authors.affiliation: Department of Anesthesiology, Louisiana State University School of Medicine, New Orleans, LA, USA. Electronic address: ckmerritt@gmail.com.
authors.forename: Christopher
authors.initials: C
authors.lastname: Merritt
authors.affiliation: Department of Anesthesiology, Louisiana State University School of Medicine, New Orleans, LA, USA. Electronic address: amitprabhakar7@gmail.com.
authors.forename: Amit
authors.initials: A
authors.lastname: Prabhakar
authors.affiliation: Department of Anesthesiology, Louisiana State University School of Medicine, New Orleans, LA, USA. Electronic address: alankaye44@hotmail.com.
authors.forename: Alan David
authors.initials: AD
authors.lastname: Kaye
authors.affiliation: Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: urmanr@gmail.com.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Urman
mesh_terms: D000009:Abdominal Muscles; D000698:Analgesia / Q000379:methods*; D000765:Anesthesia, Conduction; D006801:Humans; D010149:Postoperative Pain / Q000188:drug therapy*; D010525:Peripheral Nerves
keywords: abdominal field block; landmark triangle of Petit block; lateral TAP block; oblique subcostal TAP block; posterior TAP block; regional anesthesia; transmuscular quadratus lomborum block; transversus abdominis plane block (TAP block)