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Transversus abdominis plane block

机译：腹横肌平面阻滞

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PURPOSE OF REVIEW: Since the publication of original work on the transversus abdominis plane (TAP) block, the translation of the research into clinical practice has resulted in some 146 articles being published in peer-reviewed journals. However, there continues to be controversies over the best approach to be used. The introduction of ultrasound should have aided the development of this block, but in fact it has caused more questions to be asked. There are a number of reviews of the block already published, but were they published too early and what is our current understanding of the TAP block and its mechanisms of action? RECENT FINDINGS: The TAP block continues to develop. We now understand that the TAP block is a multifaceted block, working with both localized field effects as well as distal effects due to a distant spread of local anesthetic. Recent research would suggest that the location of needle tip placement causes variation in the block characteristics obtained. The more anterior approaches adopted for use since the introduction of ultrasound might be better described as RAFI (regional abdominal field infiltration) blocks. SUMMARY: The TAP block, in all its guises, is an effective analgesic tool, but what is the best approach? Randomized controlled trials comparing the TAP/RAFI blocks to epidural based analgesia are required.
机译：审查目的：自有关腹横肌平面（TAP）区块的原始工作发表以来，该研究被转化为临床实践后，已有146篇文章发表在同行评审期刊上。但是，关于使用的最佳方法仍然存在争议。超声波的引入本应有助于这种阻滞的发展，但实际上它引起了更多的问题。已经对该区块发表了许多评论，但是它们发表得为时过早吗？我们对TAP区块及其作用机制的当前理解是什么？最近的发现：TAP块继续发展。现在我们了解到，TAP阻滞是一个多方面的阻滞，既可以发挥局部场效应，又可以因远距离扩散局部麻醉剂而产生远端效应。最近的研究表明，针尖位置的位置会导致所获得的块状特征发生变化。由于引入了超声波，因此采用的更前路的方法可能被更好地描述为RAFI（区域腹腔浸润）阻滞。简介：TAP阻滞剂的所有形式都是一种有效的镇痛工具，但是最好的方法是什么？需要将TAP / RAFI阻滞与硬膜外镇痛进行比较的随机对照试验。

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