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.