Regarding the TAP block, check the true statement:

 

 

A) The subcostal approach provides analgesia of the lower quadrants of the abdomen (T11-L1 dermatomes)

 

B) Has no effect on visceral pain

 

C) Is not indicated in urological surgery

 

D) The local anesthetic should be deposited in the plane between the external and internal oblique muscles

 

 

Solution:

 

The TAP block is the transversus abdominis plane block. For proper dispersion of the LA, this should be placed in the fascial plane between the internal oblique and transversus abdominis muscles, where the spinal afferent nerves that innervate the anterior abdominal wall pass through.

 

Several approaches have been described, such as the posterior approach through the triangle of Petit, responsible for the analgesia of the lower quadrant of the abdomen (dermatomes T11-L1), the subcostal approach responsible for the analgesia of the superior quadrant (dermatomes T6-T10), and more recently the oblique subcostal approach, which appears to be effective in the analgesia of the entire abdomen (L1 dermatomes T6).

 

This block has been increasing its clinical applicability, currently being used in intra and post–operative analgesic control of abdominal, urologic, gynecologic, obstetric and pediatric surgeries. However, the visceral pain, the retroperitoneum and abdominal posterolateral wall from the anterior axillary line is not covered, so if those areas have involvement you should associate intravenous opioids.

 

 

QUESTIONS & ANSWERS...  SOLUTION 5

Source: NYSORA