[Why and how to perform an ultrasound-guided transversus abdominis plane block: A step-by-step approach].
Used in clinical practice as part of a multimodal analgesic regimen, the transversus abdominis plane block (TAP block) is a relative novel procedure in which local anaesthetic agents are injected into the anatomic neurofascial space between the internal oblique and the transversus abdominis muscle. It allows a significantly prolonged duration of analgesia during the early postoperative stage in abdominal surgery. This regional anesthesia technique provides analgesia to the skin, muscles of the anterior abdominal wall and parietal peritoneum in order to decrease the incision-related pain. Thus, it reduces postoperative opiate requirements and opioids-related side effects (nausea, vomiting, delayed resumption of intestinal transit, drowsiness, respiratory depression, urine retention). Additionally, the TAP block appears particularly interesting when neuraxial techniques or opioids are contraindicated. Moreover, the ultrasound-guided procedure provides a significant success rate of this block and additionally avoids major complications. We describe our technique of ultrasound-guided TAP block and discuss its indications, contraindication and potential complications.
Service de gynécologie-obstétrique, centre hospitalier de Thiers, route du Fau, 63300 Thiers, France; EA 4681, PEPRADE, Clermont université, université d'Auvergne, 63000 Clermont-Ferrand, France. Electronic address: enohuz@yahoo.fr.
E
E
Nohuz
Service d'anesthésie-réanimation, centre hospitalier de Thiers, route du Fau, 63300 Thiers, France.
B
B
El Drayi
Service d'anesthésie-réanimation, centre hospitalier de Thiers, route du Fau, 63300 Thiers, France.
A
A
Triki
Service d'anesthésie-réanimation, centre hospitalier de Thiers, route du Fau, 63300 Thiers, France.
K
K
Grossmannova
Service d'anesthésie-réanimation, centre hospitalier de Thiers, route du Fau, 63300 Thiers, France.
B
B
Boudier
Service d'anesthésie-réanimation, centre hospitalier de Thiers, route du Fau, 63300 Thiers, France.
K
K
Koffi
Service de gynécologie-obstétrique, centre hospitalier de Thiers, route du Fau, 63300 Thiers, France.
M
M
Albaut
Service d'anesthésie-réanimation, hôpital Gabriel-Montpied, centre hospitalier universitaire de Clermont-Ferrand, 63000 Clermont-Ferrand, France.
C
C
Dualé
D000005:Abdomen / Q000601:surgery*; D000009:Abdominal Muscles / Q000187:drug effects*; D000698:Analgesia / Q000379:methods*; D000700:Analgesics / Q000008:administration & dosage; D000758:Anesthesia / Q000379:methods*; D000777:Anesthetics / Q000008:administration & dosage; D002585:Cesarean Section / Q000379:methods; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D009407:Nerve Block / Q000009:adverse effects / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control; D011247:Pregnancy; D014463:Ultrasonography
D000700:Analgesics; D000777:Anesthetics
Analgésie multimodale; Cesarean section; Césarienne; Cœlioscopie; Douleur postopératoire; Laparoscopy; Laparotomie; Laparotomy; Multimodal analgesia; Postoperative pain; TAP block; Transversus abdominis plane block