Use of TAP block in a patient with poor CPEX testing during major abdominal surgery

摘要

The transversus abdominis plane (TAP) block provides anaesthesia to the anterior abdominal wall. It can be performed using landmark techniques via the Triangle of Petit or using ultrasound guidance. It is an effective tool in postoperative pain management for patients undergoing anterior abdominal wall surgery. It produces a significant reduction in postoperative pain scores, thereby reducing opioid consumption and the incidence of associated side-effects. Cardiopulmonary exercise (CPEX) testing provides a non-invasive method of assessing combined pulmonary, cardiac and circulatory function. It quantifies patient’s functional ability to respond to the increased metabolic demands of major surgery and is commonly used to assess mortality risk preoperatively. The use of CPEX testing to predict postoperative complications is not fully defined. We report the case of a patient with poor functional capacity and a CPEX test indicating high risk, who underwent uneventful intra-abdominal surgery with the use of bilateral TAP blocks