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How To Perform an Ultrasound-Guided TAP Block for Appendicitis Pain

By Arun Nagdev, MD, Sally Mahmoud, MD, and Daniel Mantuani, MD, MPH | on May 17, 2019 | 0 Comment
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Figure 1A: The lateral ultrasound-guided TAP block will provide innervation to the anterior cutaneous branches of T10 to T12 (approximately the space highlighted). Figure 1B: Surface landmarks that should be palpated (if possible) include the inferior costal margin and the iliac crest. Place the ultrasound transducer between these two landmarks.

Conclusion

Acute pain management is the responsibility of the emergency physician. Multimodal pathways that allow clinicians a method to tailor pain management to the needs of the patient will reduce the reliance on opioid-only algorithms and improve patient care. Our multidisciplinary model for treating pain from acute appendicitis has proved successful due to a non-siloed approach to offering best practices to our patients.

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Explore This Issue
ACEP Now: Vol 38 – No 05 – May 2019

References

  1. Beaudoin FL, Haran JP, Liebmann O. A comparison of ultrasound-guided three-in-one femoral nerve block versus parenteral opioids alone for analgesia in emergency department patients with hip fractures: a randomized controlled trial. Acad Emerg Med. 2013;20(6):584-591.
  2. Durant E, Dixon B, Luftig J, et al. Ultrasound-guided serratus plane block for ED rib fracture pain control. Am J Emerg Med. 2017;35(1):197.e3-197.e6.
  3. Herring AA. Bringing ultrasound-guided regional anesthesia to emergency medicine. AEM Educ Train. 2017;1(2):165-168.
  4. Lewiss RE, Tayal VS, Hoffmann B, et al. The core content of clinical ultrasonography fellowship training. Acad Emerg Med. 2014;21(4):456-461.
  5. Akhtar S, Theodoro D, Gaspari R, et al. Resident training in emergency ultrasound: consensus recommendations from the 2008 Council of Emergency Medicine Residency Directors Conference. Acad Emerg Med. 2009;16(4):S32-36.
  6. Niraj G, Searle A, Mathews M, et al. Analgesic efficacy of ultrasound-guided transversus abdominis plane block in patients undergoing open appendicectomy. Br J Anaesth. 2009;103(4):601-605.
  7. Tsai HC, Yoshida T, Chuang TY, et al. Transversus abdominis plane block: an updated review of anatomy and techniques. Biomed Res Int. 2017;2017:8284363.
  8. Mahmoud S, Miraflor E, Martin D, et al. Ultrasound-guided transverse abdominis plane block for ED appendicitis pain control. Am J Emerg Med. 2019;37(4):740-743.

Pages: 1 2 | Single Page

Topics: AppendicitisOpioid CrisisUltrasoundUltrasound-Guided Nerve Block

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