Application of the transversus abdominis plane block in the intensive care unit

We present three patients admitted to the intensive care unit following major intra-abdominal surgery who underwent ultrasound guided transversus abdominis plane (TAP) block for postoperative analgesia. In two patients, epidural analgesia was relatively contraindicated. In the third patient, the TAP block was used to provide rescue analgesia in the setting of an ineffective epidural. We found that the TAP blocks provided satisfactory analgesia and appeared to enhance recovery by reducing morphine requirements and avoiding opioid-related side-effects. We put forward a case for more frequent use of this simple and safe technique in the intensive care setting.