Continuous Transversus Abdominis Plane Block

Abstract

A procedure and kit are provided for performing an ultrasound-guided transversus abdominis plane (TAP) procedure. The patient's abdomen is scanned with an ultrasound probe to identify and mark the external oblique, internal oblique, and TAP. An introducer sheath is placed over a fluid delivery needle such that the distal end of the needle extends beyond the distal end of the sheath, the needle having echogenic properties for ultrasound imaging. The needle and sheath are ultrasonically guided into the TAP. A local anesthetic or saline/anesthetic combination is injected through the needle to create a liquid pool in the TAP. The needle is removed from the sheath while maintaining the sheath within the TAP and a catheter is subsequently advanced through the sheath and into the pooled liquid in the TAP. The sheath is withdrawn while maintaining the catheter located within the TAP. A catheter is connected to a source of local anesthetic for providing a defined volume of anesthetic to the catheter site at a controlled delivery rate.

What is claimed is: 
     
         1 . A medical procedure kit for performing an ultrasound-guided transversus abdominis plane (TAP) procedure, said kit comprising:
 a container, said container further comprising:
 a fluid delivery needle having a length and gauge for penetration into a patient's TAP; 
 an extension set having a distal end that mates with said fluid delivery needle; 
 a sheath having a size and length such that said needle slides into said sheath and extends distally beyond a distal end of said sheath; and 
 a TAP catheter having a size and length so as to slide through said sheath, said TAP catheter comprising a reservoir having a defined fill volume and flow rate for delivery of a local anesthetic through said catheter. 
   
     
     
         2 . The medical procedure kit as in  claim 1 , further comprising a local anesthesia and at least one syringe that mates with a proximal end of said extension set to delivery said local anesthesia through said needle. 
     
     
         3 . The medical procedure kit as in  claim 1 , further comprising any combination of drape, dressings, or tape. 
     
     
         4 . The medical procedure kit as in  claim 1 , wherein said extension set comprising an extension tube and a 90-degree adapter that mates with said needle. 
     
     
         5 . The medical procedure kit as in  claim 1 , wherein said needle is a fixed wing Weiss epidural needle with a Tuohy point. 
     
     
         6 . The medical procedure kit as in  claim 1 , wherein said container comprises a sealed tray. 
     
     
         7 . The medical procedure kit as in  claim 1 , wherein said sheath comprises a proximal handle and a semi-rigid, echogenic section having a length so as to extend into the patient's TAP subsequent to removal of said needle from said sheath. 
     
     
         8 . The medical procedure kit as in  claim 7 , wherein said sheath is rendered echogenic by a plurality of perforations defined along said echogenic section.