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CASE REPORT article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 12 - 2025 |
doi: 10.3389/fmed.2025.1541462
This article is part of the Research Topic Mechanisms and Interventions for Post-Operative Neurocognitive Disorder and Sleep Disruptions View all 7 articles
Ultrasound-guided transversus abdominis plane block as an adjunctive anesthesia technique in elderly patients with combined massive ascites: a case report and literature review
Provisionally accepted- 1 Qingdao University Medical College, Qingdao, China
- 2 Chinese Medicine Hospital of Qingdao City, Qingdao, Shandong Province, China
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 9000 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.
Keywords: ovarian tumor excision, Transversus abdominal plane block, Elderly, Ascites, ultrasound, case report
Received: 07 Dec 2024; Accepted: 28 Jan 2025.
Copyright: © 2025 Zhang, Liu, Wang, Zhang and Hu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Aihong Liu, Chinese Medicine Hospital of Qingdao City, Qingdao, Shandong Province, China
Lei Wang, Chinese Medicine Hospital of Qingdao City, Qingdao, Shandong Province, China
Yanping Zhang, Chinese Medicine Hospital of Qingdao City, Qingdao, Shandong Province, China
Zhaolan Hu, Chinese Medicine Hospital of Qingdao City, Qingdao, Shandong Province, China
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