Ultrasound-guided transversus abdominis plane block: Analgesic benefits for postoperative pain control after an emergent femorofemoral bypass surgery

Background: Transversus abdominis plane (TAP) block via the single-shot or the insertion of a catheter can provide postoperative analgesia for a range of surgeries involving the anterior abdominal wall. Case presentation: We... [ view full abstract ]

Background: Transversus abdominis plane (TAP) block via the single-shot or the insertion of a catheter can provide postoperative analgesia for a range of surgeries involving the anterior abdominal wall.

Case presentation: We present a case of 79-year-old female patient with a complex past medical history that includes atrial fibrillation, embolic stroke, and congestive heart failure with an fraction of 31%, who underwent an emergent femorofemoral bypass and had adequate perioperative pain relief after the ultrasound-guided TAP block. Bilateral TAP block was performed with a 3.5-inch long, 21 G stimuplex needle, using 50 ml of 0.25% bupivacaine with 1:200,000 epinephrine and 2 mg of dexamethasone. Prior to her discharge from the hospital on postoperative day 7, patient required administration of only a single dose of oral PRN medication.

Coclusion: TAP block, which in our case utilized 0.25% bupivacaine with epinephrine and supplemented with 2mg dexamethasone, provided an elderly patient status post an emergent femorofemoral bypass with a great analgesic benefit, allowing the patient to consume minimal analgesics.