Transversus Abdominis Plane Block

  • Anesthesia to Parietal Peritoneum and Abdominal Wall
  • Controversial: T7-L1 varies depending on study
  • Useful in Acute and Chronic Pain Settings


  • Postoperative Abdominal Pain (Acute and Chronic)
  • Postabdominal incison pain 
    • Appendectomy
    • Radical Prostatectomy
    • Hernia Repair
  • Somatic Abdominal Pain

Relevant Anatomy

  • Abdominal wall innervation arises from T7 to L1
  • Includes 
    • Intercostal T7-T11
    • Subcostal T12
    • Iliohypogastric and Ilioinguinal (L1)

Triangle of Petit

  • The floor of the triangle is composed, from superficial to deep, of the fascial extensions of external oblique, internal  oblique, and transversus abdominis, respectively, and the peritoneum.  

Locating the Transverse Abdominis Plane

Scanning from the flank anteriorly

Visualize the quadratus lumborum muscle and slide your probe anteriorly to visualize the tranversus abdominis fascia and the formation fo the 3 muscle layers. The External Oblique, Internal Oblique and Transversus Abdominis Muscles.

Subcostal TAP Block

Locating and Indications

Located in the upper outer quadrant of the abdomen, the subcostal Transversis Abdominis Plane is found under the most inferior rib. This block is useful for anesthetizing the upper abdomen which may be missed during the classic TAP Block described above.


  • Peritoneal perforation

  • Bowel Hematoma

  • Femoral nerve palsy

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and Interesting Articles

  • Hammi C, Ahn K. Transversus Abdominis Plane Block. [Updated 2022 Oct 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from:
  • Lissauer J, Mancuso K, Merritt C, Prabhakar A, Kaye AD, Urman RD. Evolution of the transversus abdominis plane block and its role in postoperative analgesia. Best Pract Res Clin Anaesthesiol. 2014 Jun;28(2):117-26. doi: 10.1016/j.bpa.2014.04.001. Epub 2014 May 9. PMID: 24993433.
  • Sethi D, Garg G. Analgesic efficacy of ultrasound-guided transversus abdominis plane block for laparoscopic gynecological surgery: a randomized controlled trial. Anesth Pain Med (Seoul). 2022 Jan;17(1):67-74. doi: 10.17085/apm.21030. Epub 2022 Jan 7. PMID: 34991187; PMCID: PMC8841257.
  • Petersen PL, Mathiesen O, Torup H, Dahl JB. The transversus abdominis plane block: a valuable option for postoperative analgesia? A topical review. Acta Anaesthesiol Scand. 2010 May;54(5):529-35. doi: 10.1111/j.1399-6576.2010.02215.x. Epub 2010 Feb 17. PMID: 20175754.


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