Ultrasound-guided transversus abdominis plane block as an adjunctive anesthesia technique in elderly patients with combined massive ascites: a case report and literature review

The ultrasound-guided transversus abdominis plane (TAP) block has emerged as an effective adjunctive analgesic technique for abdominal surgery. However, its use in older patients with significant ascites has been rarely documented. This report presents the anesthetic management of an older patient w...

Full description

Saved in:
Bibliographic Details
Main Authors: Liwen Zhang, Aihong Liu, Lei Wang, Yanping Zhang, Zhaolan Hu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1541462/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850235977265577984
author Liwen Zhang
Aihong Liu
Lei Wang
Yanping Zhang
Zhaolan Hu
author_facet Liwen Zhang
Aihong Liu
Lei Wang
Yanping Zhang
Zhaolan Hu
author_sort Liwen Zhang
collection DOAJ
description The ultrasound-guided transversus abdominis plane (TAP) block has emerged as an effective adjunctive analgesic technique for abdominal surgery. However, its use in older patients with significant ascites has been rarely documented. This report presents the anesthetic management of an older patient with massive ascites undergoing open laparotomy for an ovarian tumor. Preoperatively, 30 mL of 0.2% levobupivacaine was injected into the TAP under ultrasound guidance. The procedure was uneventful, with approximately 9,000 mL of ascitic fluid drained, along with the removal of a 13 × 13 × 7-cm left ovarian mass, an 8 × 5.5 × 4-cm uterus, and a 3.5 × 1 × 0.5-cm right ovary. Throughout the surgery, the patient maintained hemodynamic stability, with no significant fluctuations in blood pressure or heart rate. Postoperatively, the patient reported minimal pain and experienced no adverse effects. These findings highlight the effectiveness of ultrasound-guided TAP block as an auxiliary anesthesia technique, providing enhanced analgesia, promoting hemodynamic stability, and improving overall anesthetic outcomes in older patients with substantial ascites.
format Article
id doaj-art-e2a5e17ba13f4f5aaf4198570e7e1df7
institution OA Journals
issn 2296-858X
language English
publishDate 2025-03-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Medicine
spelling doaj-art-e2a5e17ba13f4f5aaf4198570e7e1df72025-08-20T02:02:05ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-03-011210.3389/fmed.2025.15414621541462Ultrasound-guided transversus abdominis plane block as an adjunctive anesthesia technique in elderly patients with combined massive ascites: a case report and literature reviewLiwen Zhang0Aihong Liu1Lei Wang2Yanping Zhang3Zhaolan Hu4Discipline of Anesthesiology, Qingdao Medical College, Qingdao University, Qingdao, ChinaDepartment of Gynecology, Qingdao Hiser Hospital Affiliated of Qingdao University (Qingdao Traditional Chinese Medicine Hospital), Qingdao, ChinaDepartment of Urology Surgery, Qingdao Hiser Hospital Affiliated of Qingdao University (Qingdao Traditional Chinese Medicine Hospital), Qingdao, ChinaDepartment of Anesthesiology, Qingdao Hiser Hospital Affiliated of Qingdao University (Qingdao Traditional Chinese Medicine Hospital), Qingdao, ChinaDepartment of Anesthesiology, Qingdao Hiser Hospital Affiliated of Qingdao University (Qingdao Traditional Chinese Medicine Hospital), Qingdao, ChinaThe ultrasound-guided transversus abdominis plane (TAP) block has emerged as an effective adjunctive analgesic technique for abdominal surgery. However, its use in older patients with significant ascites has been rarely documented. This report presents the anesthetic management of an older patient with massive ascites undergoing open laparotomy for an ovarian tumor. Preoperatively, 30 mL of 0.2% levobupivacaine was injected into the TAP under ultrasound guidance. The procedure was uneventful, with approximately 9,000 mL of ascitic fluid drained, along with the removal of a 13 × 13 × 7-cm left ovarian mass, an 8 × 5.5 × 4-cm uterus, and a 3.5 × 1 × 0.5-cm right ovary. Throughout the surgery, the patient maintained hemodynamic stability, with no significant fluctuations in blood pressure or heart rate. Postoperatively, the patient reported minimal pain and experienced no adverse effects. These findings highlight the effectiveness of ultrasound-guided TAP block as an auxiliary anesthesia technique, providing enhanced analgesia, promoting hemodynamic stability, and improving overall anesthetic outcomes in older patients with substantial ascites.https://www.frontiersin.org/articles/10.3389/fmed.2025.1541462/fullovarian tumor excisiontransversus abdominal plane blockelderlyascitesultrasoundcase report
spellingShingle Liwen Zhang
Aihong Liu
Lei Wang
Yanping Zhang
Zhaolan Hu
Ultrasound-guided transversus abdominis plane block as an adjunctive anesthesia technique in elderly patients with combined massive ascites: a case report and literature review
Frontiers in Medicine
ovarian tumor excision
transversus abdominal plane block
elderly
ascites
ultrasound
case report
title Ultrasound-guided transversus abdominis plane block as an adjunctive anesthesia technique in elderly patients with combined massive ascites: a case report and literature review
title_full Ultrasound-guided transversus abdominis plane block as an adjunctive anesthesia technique in elderly patients with combined massive ascites: a case report and literature review
title_fullStr Ultrasound-guided transversus abdominis plane block as an adjunctive anesthesia technique in elderly patients with combined massive ascites: a case report and literature review
title_full_unstemmed Ultrasound-guided transversus abdominis plane block as an adjunctive anesthesia technique in elderly patients with combined massive ascites: a case report and literature review
title_short Ultrasound-guided transversus abdominis plane block as an adjunctive anesthesia technique in elderly patients with combined massive ascites: a case report and literature review
title_sort ultrasound guided transversus abdominis plane block as an adjunctive anesthesia technique in elderly patients with combined massive ascites a case report and literature review
topic ovarian tumor excision
transversus abdominal plane block
elderly
ascites
ultrasound
case report
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1541462/full
work_keys_str_mv AT liwenzhang ultrasoundguidedtransversusabdominisplaneblockasanadjunctiveanesthesiatechniqueinelderlypatientswithcombinedmassiveascitesacasereportandliteraturereview
AT aihongliu ultrasoundguidedtransversusabdominisplaneblockasanadjunctiveanesthesiatechniqueinelderlypatientswithcombinedmassiveascitesacasereportandliteraturereview
AT leiwang ultrasoundguidedtransversusabdominisplaneblockasanadjunctiveanesthesiatechniqueinelderlypatientswithcombinedmassiveascitesacasereportandliteraturereview
AT yanpingzhang ultrasoundguidedtransversusabdominisplaneblockasanadjunctiveanesthesiatechniqueinelderlypatientswithcombinedmassiveascitesacasereportandliteraturereview
AT zhaolanhu ultrasoundguidedtransversusabdominisplaneblockasanadjunctiveanesthesiatechniqueinelderlypatientswithcombinedmassiveascitesacasereportandliteraturereview