Ultrasound guided transversus abdominis plane block in infants, children and adolescents: a simple procedural guidance for their performance

The transversus abdominis plane block (TAP) has been described recently for pain management following abdominal surgery. Although many techniques have been described using anatomical landmarks, a simple ultrasound (US) guidance technique for the block has not been described in children. An article published by Hebbard and colleagues on the use of US-guidance for TAP blocks described the technique with the probe positioned at the midaxillary line with a needle insertion that is located further medial on the abdominal wall. This technique, although feasible in adults is not possible in children due to the need for obtaining a more thorough spread of the local anesthetic solution. We describe in this article, a user-friendly approach to the placement of a TAP block in infants, children and adolescents. Further pharmacokinetic data has to be obtained for actual dosing for these blocks in infants and children.