Intra-Operative TAP Block for Improved Analgesia in Abdominoplasty

Goals/Purpose:  To demonstrate the performance and usefulness of the intra-operative TAP (transversus abdominis plane) regional block during abdominoplasty surgery, for improved patient comfort in the immediate postoperative period.  

Methods/Technique: Following elevation of the abdominal flap and repair of rectus diastasis, a limited 1" dissection is performed bilaterally through the external and internal oblique muscles using a muscle-splitting technique, at the level of the umbilicus.  Using a blunt-tipped injection cannula, local anesthesia is placed under direct vision into the TAP plane, and the external oblique fascia is then repaired.  Time to perform the block is less than 10 minutes.   

Results/Complications: Abdominoplasty patients who received the TAP block as part of their body contouring were significantly more comfortable in the PACU and for the first 12 hours post-procedure than those who had the standard technique, based on pain scores and amount of narcotics used. 

Conclusion: The TAP block is a useful adjunct to abdominoplasty, providing a more comfortable initial recovery.  It can be performed rapidly and easily using standard surgical instruments, and without the need for ultrasound guidance.