Lissauer Jonathan, Mancuso Kenneth, Merritt Christopher, Prabhakar Amit, Kaye Alan David, Urman Richard D
Department of Anesthesiology, Louisiana State University School of Medicine, New Orleans, LA, USA.
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Best Pract Res Clin Anaesthesiol. 2014 Jun;28(2):117-26. doi: 10.1016/j.bpa.2014.04.001. Epub 2014 May 9.
Since it was first described by Rafi in 2001, the transversus abdominis plane (TAP) block can be best described as a peripheral nerve block to the anterior abdominal wall (T6 to L1). The TAP block is specifically a local anesthetic injection into the fascial plane superficial to the transversus abdominis muscle and deep to the internal oblique muscle. The TAP block has been a subject of controversy with regard to utility, to indications, and more fundamentally, how best to place the block and its precise mechanism of action. The evolution of thinking with regard to this block, or more correctly family of interrelated blocks, includes knowledge of underlying anatomy, as well as an appreciation of its varied approaches. The TAP block affords excellent analgesia for abdominal procedures. In summary, the TAP block affords effective analgesia with opioid sparing effects, technical simplicity, and long duration of action. Some disadvantages include the need for bilateral block for midline incisions and absence of effectiveness for visceral pain.
自2001年拉菲首次描述腹横肌平面（TAP）阻滞以来，它可被最好地描述为一种对前腹壁（T6至L1）的外周神经阻滞。TAP阻滞具体是将局部麻醉药注射到腹横肌浅面和腹内斜肌深面的筋膜平面。TAP阻滞在效用、适应证方面一直存在争议，更根本的是，关于如何最佳地实施该阻滞及其确切作用机制也存在争议。关于这种阻滞，或者更确切地说是相关阻滞家族的认识演变，包括对基础解剖结构的了解，以及对其多种方法的认识。TAP阻滞为腹部手术提供了出色的镇痛效果。总之，TAP阻滞能提供有效的镇痛，具有节省阿片类药物的作用、技术简单且作用时间长。一些缺点包括中线切口需要双侧阻滞以及对内脏痛无效。
