title: Transversus abdominis plane block as the primary anesthetic for laparotomy.
abstract: 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.
authors.affiliation: Department of Anesthesiology, Penn State College of Medicine, Hershey, PA, USA.
authors.forename: Julie T
authors.initials: JT
authors.lastname: Vuong
authors.affiliation: Department of Anesthesiology, Penn State College of Medicine, Hershey, PA, USA.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: McQuillan
authors.affiliation: Department of Surgery, Penn State College of Medicine, Hershey, PA, USA.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Messaris
authors.affiliation: Department of Anesthesiology, Penn State College of Medicine, Hershey, PA, USA.
authors.forename: Sanjib Das
authors.initials: SD
authors.lastname: Adhikary
keywords: Laparotomy; primary anesthetic; transversus abdominis plane block