The analgesic efficacy of preoperative ultrasound-guided transversus abdominis plane block in fat harvesting from the lower abdomen under local anesthesia: A preliminary case series

Abstract

Background Small-volume liposuction can be performed under local anesthesia, but intolerable pain usually occurs during the perioperative period. This study evaluated the analgesic effect of ultrasound-guided transverse abdominis plane (TAP) block prior to harvesting a small volume of fat from the lower abdomen under local anesthesia and to demonstrate the safety and efficacy of this technique. Methods Eight patients who participated in a clinical trial of injecting autologous adipose-derived stromal cells obtained from small-volume liposuction of the lower abdomen from May 2020 to July 2020 were included in this study. Ultrasound-guided TAP block was performed 30 minutes before the main procedure. A total of 15 mL of a mixture of 2% lidocaine (20 mL) and normal saline (10 mL) was injected into the fascia layer between the internal oblique muscle and transverse abdominis muscle. Subjective pain was evaluated through questionnaires by a verbal numerical rating scale (VNRS) at the time of tumescent infiltration and 1, 2, 4, and 6 hours after the operation. Results The median time required for TAP block was 14 minutes (range, 10–21 minutes). The median VNRS score was 3.0 at the time of tumescent solution infiltration, 1.5 at postoperative 1 hour and 2 hours, and 2.0 at postoperative 4 and 6 hours. No complications occurred in relation to the TAP block procedure, including infection, inflammation, hematoma, nerve palsy, or bowel perforation. Conclusions Ultrasound-guided TAP block prior to small-volume liposuction of the lower abdomen was confirmed to be a safe and effective technique for perioperative analgesia.

Keywords

• transverse abdominis plane
• liposuction
• local anesthesia