BoardsBridgeTAP Block for Laparotomy
Ultrasound-guided transversus abdominis plane block as part of multimodal analgesia when neuraxial is contraindicated or unavailable
Ultrasound-guided transversus abdominis plane (TAP) block deposits local anesthetic between the internal oblique and transversus abdominis, anesthetizing the T6–L1 thoracolumbar nerves for somatic abdominal wall analgesia after laparotomy — but does NOT cover visceral peritoneum or referred shoulder pain.
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Headline: Somatic wall analgesia only (T6–L1) — NO visceral coverage and NO shoulder (phrenic) coverage
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Key numbers
- Volume per side: 15–20 mL of long-acting LA in the fascial plane
- Ropivacaine max dose: 3 mg/kg (e.g. 0.375% × 15 mL × 2 sides ≈ 113 mg in 70 kg adult)
- Bupivacaine max dose: 2 mg/kg (cardiotoxicity:CNS toxicity ratio is narrow — be cautious)
- Lidocaine max dose: 4.5 mg/kg plain, 7 mg/kg with epinephrine
- PRAN pediatric safety cohort: 1,994 cases — overall LOW adverse-event rate
Uri Rozen, MD — Licensed Physician, Israel
Source guidelines: SVS Perioperative Vascular Care 2022 · ESRA ASRA Pediatric Regional Dosing 2018 · LAST Narrative Review 2023
Re-review cadence: 12 months from reviewed date.
Related on BoardsBridge
Card ID: tap-laparotomy · Path: aba.regional.truncal.tap-laparotomy