Transversus Abdominis Plane Block: A New Gold Standard for Abdominal Surgery?

Fifteen years have now elapsed since the first publication appeared on Transversus Abdominis Plane (TAP) block, by Rafi et al. [1] it has described as the deposition of local anaesthetic drug in the neurovascular plane sited between transversus muscle and internal oblique muscle in correspondence of lumbar triangle of Petit, the anatomical space formed by the margin of the latissimus dorsi posteriorly, the margin of the external oblique anteriorly and the iliac crest inferiorly. To 200 patients undergoing to abdominal surgeries, in lateral position, he applied a blind technique to individuate this virtual space, through the “double-pop technique”: the needle insertion in this area is guided by felting of the first pop, for the passage from external to internal oblique muscle, and the second pop, from the internal oblique to transversus abdominis muscle; a volume of 20 ml of anaesthetic is deposited into this space after induction of anaesthesia and prior to surgery, obtaining a good control of pain in children and adult patients.