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TAP blocks (nerve blocks) for analgesia after abdominal surgery

Charlton S, Cyna AM, Middleton P, Griffiths JD
Published Online: 
8 December 2010

Poorly controlled pain after abdominal surgery is associated with a variety of unwanted post-operative consequences, including patient suffering, distress, confusion, chest and heart problems, and prolonged hospital stays. Traditionally, pain relief is provided by: medications injected in to a vein using a 'drip' such as morphine or paracetamol; administering local anaesthetic into the skin around the surgical wound; or by providing epidural pain relief where local anaesthetic and other pain relieving medications are injected through a fine plastic tube into the epidural space of the lower back - numbing the nerves that supply the abdomen. Following surgery, Transversus Abdominis Plane (TAP) block is a relatively new way of anaesthetising nerves which numb the abdomen after surgery in order to help improve patient comfort after their surgery. In the past few years, there has been increasing research and interest describing how TAP blocks are being used for pain relief in both adults and children having abdominal surgical procedures. However, there have not been any systematic reviews evaluating the effectiveness of the TAP block in reducing pain after surgery. We have searched for research investigating the effectiveness of rectus sheath (a similar block to TAP) and TAP blocks in providing pain relief after abdominal surgery. We have included eight studies, with a total of 358 participants in this review, that show some limited evidence that TAP blocks improve pain relief after abdominal surgery. More research is indicated, comparing TAP blocks with other standard methods of pain relief such as, morphine medication, epidural analgesia and local anaesthetic injection into and around the surgical wound. There are many studies currently underway or awaiting publication which assess the effectiveness of the TAP block and compare it with other techniques. We intend to include these studies in an updated version of this review in the near future.