Abstract

The transverse abdominis plane (TAP) block has been suggested as a pain management adjunct for laparoscopic surgical approaches. The administration of a TAP block involves using ultrasound guidance to inject local anesthetic into the fascial plane between the internal oblique and transversus abdominis muscles. Current evidence demonstrates that the utilization of TAP blocks lead to lower postoperative pain scores and overall lower narcotic consumption in the postoperative period. A 64-year-old female presented for a laparoscopic assisted vaginal hysterectomy. After induction of general anesthesia with placement of an endotracheal tube, a bilateral TAP block was administered by the anesthesiologist. During the ultrasound guided block placement, the anesthesiologist expressed difficulty in identifying clear anatomical structures and concerns for potential failed block efficacy. The patient had a significant response to surgical stimulation with a sustained increase in heart rate and blood pressure noted. Additional doses of narcotic medication and a higher concentration of anesthetic gas was required to maintain adequate hemodynamics for the remainder of the case. The patient emerged from anesthesia and extubated without issue. In the post anesthesia care unit, the patient reported pain rated 7 out of 10 and required additional doses of narcotic medications then and during their overnight admission for pain management. It is surmised that the patient had a failed TAP block as evidenced by the uncertainty of the anesthesiologist during block placement and the much higher requirement of narcotic medication required during the intraoperative and postoperative period. This led to the clinical question, In patients undergoing laparoscopic surgery, does the utilization of a TAP block result in decreased pain scores and narcotic use in the perioperative period when compared to a TAP block not being administered?

Author Details

Riley Byars, DNP(c), BSN, RN - 3 years of experience as an ICU RN senior SRNA; David Fort, DNP, CRNA

Sigma Membership

Non-member

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Case Study/Series

Research Approach

Mixed/Multi Method Research

Keywords:

Transversus Abdominis Plane Block, TAP Block, Laparoscopic Surgery, Abdominal Surgery, Gynecological, Regional Technique, Nerve Block

Advisor

Terri M. Cahoon

Degree

DNP

Degree Grantor

Samford University

Degree Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Proxy-submission

Date of Issue

2026-03-24

Full Text of Presentation

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Additional Files

Abstract.pdf (217 kB)

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