Anesthesia Experience for Open Gastrostomy With Ultrasound-Guided Unilateral Subcostal Transversus Abdominis Plane Block in a High Risk Elderly Patient: A Case Report

Abstract

Introduction: Many papers have reported that TAP block provides effective postoperative analgesia, but the sole use of TAP block for surgical anesthesia has been rarely reported. Case Presentation: Therefore, we presented an 80-year-old male undergoing ultrasound-guided unilateral subcostal TAP block providing surgical anesthesia for open gastrostomy. Left subcostal TAP block was performed using the method described by Hebbard with the M-Turbo® ultrasound system and a linear probe placing immediately inferior and parallel to the costal margin. Using a 100 -mm long, 23 G short-bevel needle in-plane technique, 20 mL of 0.25% levobupivacaine was injected on the TAP. A sensory block from T7 to T11 was established and the satisfaction score was 7 - 8. Conclusions: Open gastrostomy was successfully performed under subcostal TAP block with small dose fentanyl supplementation. The subcostal TAP block is considered a useful anesthetic choice in surgery for high risk patients.