Clinical Implications of the Transversus Abdominis Plane Block in Adults

Table 1

List of published clinical studies on the use of TAP blocks. Single patient case reports have been excluded. (*) 20 patients were randomized to receive TAP block and spinal block with plain bupivacaine, while 20 patients were randomized to receive TAP block, bupivacaine spinal block, and intrathecal morphine. (**) Volume includes some local anesthetic used to perform ilioinguinal block in conjunction with TAP block. US-guided: ultrasound-guided. L-bupivacaine: Levobupivacaine.

Reference	Study sample	Local anesthetic	Block operator	Surgical procedure	Outcome
Sforza et al., 2011 [21]	14 cases; 14 controls	10 mL/side of 0.5% bupivacaine with 10 mL/side lidocaine + 1 : 200,000 epinephrine	Surgical team	Abdominoplasty	Superior analgesia compared to IV/PO medications
Kadam and Moran 2011 [22]	15 cases; 15 controls	8 mL/hr/side (continuous bilateral catheters) of 0.2% ropivacaine	Anesthesia team	Variety of upper and/or lower abdominal surgery	Noninferior outcome compared to epidural analgesia
Hivelin et al., 2011 [23]	15 cases; 15 controls	1.5 mg/kg/side of 0.475% ropivacaine	Surgical team	Breast reconstruction with deep inferior epigastric perforator flap	Superior analgesia compared to IV/PO medications
McMorrow et al.,; 2011 [24]	40 cases; 40 controls*	1 mg/kg/side of 0.375% bupivacaine	Anesthesia team	C-section	Inferior analgesia compared to intrathecal morphine
Mei et al.,; 2011 [25]	4 cases	20 mL/side** of 0.5% ropivacaine	Anesthesia team (US-guided)	C-section	Superior analgesia compared to local infiltration
Bharti et al., 2011 [17]	20 cases; 20 controls	20 mL/side of 0.25% bupivacaine	Surgical team	Colorectal surgery	Superior analgesia compared to IV/PO medications
Børglum et al. 2011 [15]	25 cases	30 mL/side of 0.25% bupivacaine	Anesthesia team (US-guided)	Various upper and/or lower abdominal surgery	Significant reduction in pain and anticipated need for IV/PO analgesics
Niraj et al.,; 2011 [26]	29 cases; 33 controls	1 mg/kg/side/8 hr (intermittent dosing through bilateral catheters) of 0.375% bupivacaine	Anesthesia team (US-guided)	Open hepatobiliary or renal surgery	Noninferior outcome compared to epidural analgesia
Aveline et al., 2011 [27]	134 cases; 139 controls	1.5 mg/kg (unilateral block) of 0.5% L-bupivacaine	Anesthesia team (US-guided)	Open inguinal hernia repair	Superior analgesia compared to landmark-based ilioinguinal/iliohypogastric nerve block
Owen et al.,; 2011 [18]	16 cases; 18 controls	20 mL/side of 0.25% bupivacaine	Surgical team	C-section	Superior analgesia compared to IV/PO medications
Gravante et al., 2011 [28]	51 cases	1 mg/kg/side of 0.5% bupivacaine	Surgical team	Abdominoplasty	Superior analgesia compared to IV/PO medications
Allcock et al., 2010 [29]	2 cases	20 mL/side bolus with 0.5% bupivacaine + 1 : 400,000 epinephrine followed by 8 mL/hr bilateral continuous infusion of 0.125% bupivacaine	Anesthesia team (US-guided)	Major thorax/abdominal trauma	Superior outcomes compared to expected results with IV/PO medications
Baaj et al.,; 2010 [30]	20 cases; 20 controls	20 mL/side of 0.25% bupivacaine	Anesthesia team (US-guided)	C-section	Superior analgesia compared to IV/PO medications
Heil et al.,; 2010 [31]	3 cases	30 mL unilateral bolus of 1.5% mepivacaine followed by 8 mL/hr continuous unilateral infusion of 0.2% ropivacaine	Anesthesia team (US-guided)	Open inguinal hernia repair	Superior outcome compared to anticipated results with IV/PO medications
Chiono et al., 2010 [32]	33 cases	15 mL (unilateral block) of 0.33% ropivacaine	Anesthesia team (US-guided)	Iliac crest bone graft	Superior outcome compared to anticipated results with IV/PO medications
Araco et al.,; 2010 [19]	34 cases; 41 controls	1 mg/kg/side of 0.5% bupivacaine	Surgical team	Abdominoplasty	Superior analgesia compared to IV/PO medications
Griffiths et al., 2010 [33]	32 cases; 33 controls	15 mL/side of 0.5% ropivacaine	Anesthesia team (US-guided)	Gynecological malignancy surgery	No benefit in analgesia compared to IV/PO medications
Lee et al.,; 2010 [34]	50 cases	20 mL of 1% ropivacaine for unilateral blocks and 20 mL/side of 0.5% ropivacaine for bilateral blocks	Anesthesia team (US-guided)	Dermatomal coverage of subcostal versus posterior approach	Most cephalad dermatome of T8 by subcostal approach versus T10 by posterior approach
Kanazi et al., 2010 [35]	29 cases; 28 controls	20 mL/side of 0.375% bupivacaine + 1 : 200,000 epinephrine	Anesthesia team (US-guided)	C-section	Inferior analgesia compared to intrathecal morphine
Mukhtar and Khattak 2010 [36]	10 cases; 10 controls	20 mL (unilateral block) of 0.5% bupivacaine	Anesthesia team	Renal transplant	Superior analgesia compared to IV/PO medications
Conaghan; et al., 2010; [37]	40 cases; 34 controls	20 mL/side of 0.25% L-bupivacaine	Anesthesia team (US-guided)	Laparoscopic colorectal surgery	Superior analgesia compared to IV/PO medications
Araco et al.,; 2010 [38]	24 cases	1 mg/kg/side of 0.5% bupivacaine	Surgical team	Abdominoplasty	Superior outcome compared to anticipated results with IV/PO medications
Asensio-Samper et al., 2010 [39]	2 cases	20 mL (unilateral block) of 0.5% ropivacaine	Anesthesia team (US-guided)	Morphine pump implantation	Superior outcome compared to anticipated results with IV/PO medications
Costello et al., 2009 [40]	47 cases; 49 controls	20 mL/side of 0.375 Ropivacaine	Anesthesia team	C-section	Noninferior outcome compared to intrathecal morphine
Jankovic et al., 2009 [41]	7 cases; 35 controls	20 mL unilateral bolus of 0.375% L-bupivacaine followed by 10 mL/hr continuous unilateral 0.15% Bupivacaine infusion	Surgical team	Renal transplant	Superior outcome compared to IV/PO medications
Niraj et al.,; 2009 [42]	3 cases	20 mL/side/12 hr of 0.5% or 0.375% bupivacaine for bilateral catheters and 25 mL/12 hr of 0.5% bupivacaine for unilateral catheter	Anesthesia team (US-guided)	Upper and/or lower abdominal surgeries	Superior outcome compared to anticipated results with IV/PO medications
Belavy et al., 2009 [43]	23 cases; 24 controls	20 mL/side of 0.5% ropivacaine	Anesthesia team (US-guided)	C-section	Superior outcome compared to IV/PO medications
Niraj et al.,; 2009 [44]	3 cases	1 mg/kg/side of 0.375% bupivacaine	Anesthesia team (US-guided)	Upper abdominal surgery	Superior outcome compared to anticipated results with IV/PO medications
Niraj et al.,; 2009 [45]	26 cases; 26 controls	20 mL (unilateral block) of 0.5% bupivacaine	Anesthesia team (US-guided)	Open appendectomy	Superior outcome compared to IV/PO medications
El-Dawlatly et al.,; 2009 [46]	21 cases; 21 controls	15 mL/side of 0.5% bupivacaine	Anesthesia team (US-guided)	Laparoscopic cholecystectomy	Superior outcome compared to IV/PO medications
Carney et al., 2008 [47]	24 cases; 26 controls	1.5 mg/kg (max 20 mL)/side of 0.75% ropivacaine	Anesthesia team	Total abdominal hysterectomy	Superior outcome compared to IV/PO medications
McDonnell; et al., 2008 [48]	25 cases; 25 controls	1.5 mg/kg (max 20 mL)/side of 0.75% ropivacaine	Anesthesia team	C-section	Superior outcome compared to IV/PO medications
McDonnell; et al., 2007 [12]	16 cases; 16 controls	20 mL/side of 0.375% L-bupivacaine	Anesthesia team	Bowel resection	Superior outcome compared to IV/PO medications
O’Donnell; 2006 [8]	12 cases	20 mL/side of 0.375% bupivacaine	Anesthesia team	Open retropubic prostatectomy	Superior outcome compared to anticipated results with IV/PO medications