Pain Management Procedures
TAP and Subcostal TAP Blocks
TAP and Subcostal TAP Blocks
What are they?
The transversus abdominis plane, or TAP, is a tissue layer between abdominal-wall muscles where several sensory nerves travel. A TAP block spreads local anesthetic through this plane to numb the abdominal wall. A subcostal TAP approach is placed higher, along the rib margin, to cover more of the upper abdomen.
When may they be recommended?
TAP blocks are most often used as part of pain control for abdominal surgery. They may also be considered for selected chronic pain that truly comes from the abdominal wall, such as pain after an incision or nerve injury. They do not reliably treat pain from organs inside the abdomen.
What happens?
You lie on your back. Ultrasound identifies the layers of abdominal muscle. After cleaning and numbing the skin, a needle is guided into the correct plane and local anesthetic is injected while its spread is observed. One or both sides may be treated.
What should I expect?
The abdominal wall may feel numb or weak. The effect usually follows the duration of the local anesthetic unless another treatment is combined. Avoid heat or injury to numb skin.
Important risks
Complications are uncommon but include bleeding, infection, local-anesthetic toxicity, temporary femoral nerve weakness, and puncture of bowel, liver, or another abdominal structure. Ultrasound reduces but does not eliminate these risks.
Preparing for your injection procedure…
Your instructions will depend on the procedure. Before any injection, tell the APG team if you:
Take aspirin, warfarin, clopidogrel, apixaban, rivaroxaban, or another medicine or supplement that affects bleeding. Never stop a prescribed blood thinner unless the clinician who manages it and the procedure team tell you how to do so safely.
Have diabetes, glaucoma, a bleeding disorder, an active infection, fever, or recent antibiotic treatment.
Could be pregnant, have an allergy to contrast dye or local anesthetic, or have reacted to steroid injections before.
Use an implanted pacemaker, defibrillator, spinal cord stimulator, or other electrical device.
Some procedures require fasting, a medication adjustment, or a responsible adult to drive you home, especially when sedation is planned. Follow the instructions provided for your specific appointment.
After your injection procedure…
Most injections are outpatient procedures. Mild soreness, bruising, temporary numbness, or a brief increase in the usual pain can occur. Follow the activity and bandage instructions you receive. Steroid medicine may take several days to have an effect and can temporarily raise blood sugar.
Call the office promptly for increasing redness, drainage, fever, severe or rapidly worsening pain, or new numbness or weakness. Seek emergency care for trouble breathing, chest pain, sudden loss of bladder or bowel control, a severe new headache, loss of vision, stroke-like symptoms, or rapidly progressing weakness.
This information is for general education and does not replace medical advice, diagnosis, or treatment. Not every procedure is appropriate for every patient, and results vary. Your APG care team will review your symptoms, examination, imaging, medical history, medications, and prior treatment before recommending a plan. Coverage requirements also vary by insurance plan.