Anesthesia: Abdominal field blocks

Administration volume and technique are critical to achieving optimal results

The videos below include a variety of surgical procedures that demonstrate examples of how to administer EXPAREL for optimal pain control and coverage.

TAP In Small Bowel Resection Performed by Dr Leiman

For more information on EXPAREL, connect with us here

This video represents an individual clinician experience with and methodology for using EXPAREL.

Pacira BioSciences, Inc., recognizes that there are other methodologies for administering local anesthetics, as well as individual patient considerations, when selecting the dose for a specific procedure.

Please see Important Safety Information below and refer to the Full Prescribing Information.

More Videos

TAP In Small Bowel Resection

TAP In Small Bowel Resection Performed by Dr Leiman

TAP In Open Hysterectomy

TAP In Open Hysterectomy Performed by Dr Hutchins

Laparoscopic Hysterectomy

Laparoscopic Hysterectomy Performed by Dr Miller

Quadratus Lumborum (QL) block

Quadratus Lumborum (QL) block Performed by Dr. Jacob Hutchins

Bilateral 4-point TAP block

Bilateral 4-point TAP block Performed by Dr. Jacob Hutchins

Classic TAP block

Classic TAP block Performed by Dr. Jacob Hutchins

Rectus Sheath TAP block

Rectus Sheath TAP block Performed by Dr. Jacob Hutchins

Subcostal TAP block

Subcostal TAP block Performed by Dr. Jacob Hutchins

Abdominal-wall field blocks are part of a multimodal strategy for postsurgical pain management1

Abdominal-wall field blocks (ie, TAP)

Use a local anesthetic to provide effective regional analgesia for a range of procedures.1

Provide analgesia to the anterior abdominal wall and involve administration of a local anesthetic into the fascial plane between the transversus abdominis and internal oblique muscles.2

Approaches to abdominal-wall field blocks continue to evolve

TAP block

Originally described as a landmark-guided field block based on the lumbar triangle1

Ultrasound-guided TAP blocks

allow visualization of the needle and local anesthetic in the plane1

Additional approaches have been and continue to be developed, including1,3:

  • Subcostal TAP
  • 4-point TAP
  • Rectus sheath blocks
  • QL blocks
  • ESP blocks

TAP blocks can be administered by the anesthesiologist or the surgeon2

Abdominal-wall can achieve sensory block in several areas

External anterior view of areas covered by PECS I and PECS II block

Classic TAP block4Yellow semicircle over the lower abdomen (dermatomes T10 to L1)

Subcostal TAP block4Can vary, or via direct visualization with laparoscopic procedures by the surgeon, but approximately the shaded gray in the upper abdominal quadrant (dermatomes T6 to T10-T12)

Bilateral 4-point TAP block5Green shape overlapping the areas of coverage of classic and subcostal TAPs (dermatomes T6 to T12)

Rectus sheath block5Narrow black oval over abdominal midline (dermatomes T6 to T12)

QL block6Large purple circle over abdominal midline (dermatomes T4 to L1)

Ultrasound-guided infiltration of the appropriate nerves can achieve a range of sensory blocks7

Images used with permission from Abdominal Best Infiltration Practices and International Guidelines Central. Artwork created by Kellie M. Holoski, 2016.

TAP, transversus abdominis plane; QL, quadratus lumborum; ESP, erector spinae.