Cutaneous Sensory Block Area, Muscle-Relaxing Effect, and Block Duration of the Transversus Abdominis Plane Block

Abstract

Cutaneous sensory block area of the TAP block is predominantly located lateral to a vertical line through the anterior superior iliac spine. The distribution is nondermatomal and does not cross the midline. The muscle-relaxing effect is significant and consistent. The block duration is approximately 10 hours with large variation.

TAP blocks for laparoscopic appendicectomy – a reply

“…We agree that we could not assess the success rate of bilateral dual transversus abdominis plane (TAP) blockade in the intervention group. We are well aware that some recent studies measuring dermatomal anaesthesia exhibit some variation [2], and our own previous studies with the bilateral dual TAP block evaluating dermatomal anaesthesia clearly show variation in whether the skin area is affected or not [3]. However, the research question in our study was whether bilateral dual TAP blockade is useful in alleviating pain after emergency laparoscopic appendicectomy and our conclusions about the usefulness of bilateral dual TAP blocks were based inter alia on measures of pain.…”

“…The size of the intergroup difference in opioid consumption was clinically relevant, even if the difference did not reach statistical significance. [1], which, contrary to current enthusiasm [2], found that the standard Macintosh blade remains a very effective tool for the overwhelming majority of patients. The Macintosh laryngoscope is reliable, robust and has stood the test of time.…”

The Erector Spinae Plane Block

“…We did observe some interindividual variability in the extent of cutaneous block, but this is not unusual in blocks based on local anesthetic spread in tissue planes. 12 The cutaneous sparing of the sternal area and neuraxial midline in unilateral ESP blockade may also be explained by overlapping innervation from the contralateral side. We recommend that further investigation should focus on confirming the reproducibility of the block, determining the extent of analgesia that can be achieved by varying the site of injection and injectate volume, and quantifying the risk of local anesthetic systemic toxicity by measuring local anesthetic plasma concentrations.…”

Interfascial Plane Blocks

“…In human volunteers, perhaps the effects of voluntary activity (eg, Valsalva maneuver, positioning, physical activity, or simulated physical therapy) on the pattern of local anesthetic spread may be mapped using clinical bedside imaging similar to a previously published study. 36 In terms of assessing access and outcomes of interfascial plane blocks, there may be role for "big data" research. Despite plenty of supporting evidence, we know that the overall utilization of regional anesthesia techniques in the perioperative management of pain continues to remain low even for common surgeries.…”