title: Anesthesia Experience for Open Gastrostomy With Ultrasound-Guided Unilateral Subcostal Transversus Abdominis Plane Block in a High Risk Elderly Patient: A Case Report.
abstract: BACKGROUND
  Many papers have reported that TAP block provides effective postoperative analgesia, but the sole use of TAP block for surgical anesthesia has been rarely reported.
  
  
  METHODS
  Therefore, we presented an 80-year-old male undergoing ultrasound-guided unilateral subcostal TAP block providing surgical anesthesia for open gastrostomy. Left subcostal TAP block was performed using the method described by Hebbard with the M-Turbo(®) ultrasound system and a linear probe placing immediately inferior and parallel to the costal margin. Using a 100 -mm long, 23 G short-bevel needle in-plane technique, 20 mL of 0.25% levobupivacaine was injected on the TAP. A sensory block from T7 to T11 was established and the satisfaction score was 7 - 8.
  
  
  CONCLUSIONS
  Open gastrostomy was successfully performed under subcostal TAP block with small dose fentanyl supplementation. The subcostal TAP block is considered a useful anesthetic choice in surgery for high risk patients.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Jeju National University Hospital, Jeju National University, Jeju, South Korea.
authors.forename: Ae Ryoung
authors.initials: AR
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Jeju National University Hospital, Jeju National University, Jeju, South Korea.
authors.forename: Yun Suk
authors.initials: YS
authors.lastname: Choe
keywords: Abdominal Muscles; Gastrostomy; Nerve Block