Introduction: To describe the technique of a surgeon-administered laparoscopic guided transversus abdominis plane block and evaluate the safety and efficacy of the block in patients underwent robot-assisted laparoscopic prostatectomy (RALP). Methods: A consecutive series of patients who underwent RALP were administered laparoscopic guided transversus abdominis plane block by the surgeon. A validated numeric pain rating scale was used to record their pain during their postoperative hospital stay. Also, the morphine milligram equivalents (MME) for pain medications were calculated. Results: A total of 61 patients were included in the analysis, 57 patients were discharged within 24 hours and 4 patients were discharged the following day. The mean pain score prior to discharge (24 hr) was 3.64 ± 1.81 (range 1-8). The MME for postoperative day 1 was 13.7 ± 11.03 (range 0-49) and 10.91 ± 8.77 (range 0-25) for postoperative day 2. There were no block related complications. Conclusions: The surgeon administered laparoscopic TAP block is a safe pain management tool. Studies compared laparoscopic guided TAP block with ultrasound-guided TAP block and reported no discernible differences in the efficacy of pain management following general surgical procedures. Direct visualization of the administration site minimizes complications such as iatrogenic visceral injury by the needle or administration of the local anesthetic in the wrong plane. In addition, the surgeon-administered block also potentially reduces the additional time taken to set up an ultrasound guided TAP block which requires an anesthesiologist and an ultrasound machine. SOURCE OF Funding: None
