EXPAREL can be used in abdominal and pectoral field blocks

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

  • Abdominal-wall field blocks use a local anesthetic to provide effective regional analgesia for a range of procedures2
  • Transversus abdominis plane (TAP) field blocks 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 muscles1
  • Approaches to abdominal-wall field blocks have been evolving
    • The TAP block was 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, including subcostal TAP, 4-point TAP, rectus sheath blocks, and quadratus lumborum (QL) blocks1,3
  • TAP blocks can be administered by the anesthesiologist or the surgeon2

Abdominal field blocks can achieve sensory block in one of several areas

Comparison of sensory blocks achieved

  • Classic TAP block4 Yellow semicircle over the lower abdomen (dermatomes T10 to L1)
  • Subcostal TAP block4 Can vary, but approximately the shaded gray in the upper abdominal quadrant (dermatomes T6 to T10-T12)
  • Bilateral 4-point TAP block5 Green shape overlapping the areas of coverage of classic and subcostal TAPs (dermatomes T6 to T12)
  • Rectus sheath block5 Narrow black oval over abdominal midline (dermatomes T6 to T12)
  • QL block6 Large 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.