Transversus abdominis plane block for placement of a paracentesis catheter with failed Fontan physiology

  • Ashfaq Kitaba Department of Pediatrics Nationwide Children’s Hospital and the Ohio State University, Columbus, Ohio (USA)
  • David P. Martin Department of Pediatrics Nationwide Children’s Hospital and the Ohio State University, Columbus, Ohio (USA)
  • Tarun Bhalla Department of Pediatrics Nationwide Children’s Hospital and the Ohio State University, Columbus, Ohio (USA)
  • Chris McKee Department of Pediatrics Nationwide Children’s Hospital and the Ohio State University, Columbus, Ohio (USA)
  • Peter Winch Department of Pediatrics Nationwide Children’s Hospital and the Ohio State University, Columbus, Ohio (USA)
  • Joseph D. Tobias Department of Pediatrics Nationwide Children’s Hospital and the Ohio State University, Columbus, Ohio (USA)
Keywords: Fontan physiology, Transversus abdominis plane (TAP) block, Postoperative analgesia

Abstract

Despite the successful palliation of patients with complex CHD, long term consequences may occur related to the chronically elevated venous pressures or failing ventricular function following total cavopulmonary anastomosis in patients with single ventricle anatomy. We present a 33-year-old adult woman with Fontan physiology who presented with recurrent ascites requiring insertion of a tunneled abdominal drain. Given her co-morbid conditions, the procedure was accomplished using a transversus abdominis plane (TAP) block placed with ultrasound guidance. Although generally used for the provision of postoperative analgesia following lower abdominal procedures, the TAP block may also be used in specific scenarios instead of general anesthesia in high risk patients. The anatomy of the TAP block is reviewed, its perioperative applications discussed, and its potential use instead of general anesthesia presented.

Published
02-03-2019
How to Cite
Kitaba, A., Martin, D. P., Bhalla, T., McKee, C., Winch, P., & Tobias, J. D. (2019). Transversus abdominis plane block for placement of a paracentesis catheter with failed Fontan physiology. Anaesthesia, Pain & Intensive Care, 179-182. Retrieved from https://apicareonline.com/index.php/APIC/article/view/494
Section
Case Reports