Unilateral Subcostal TAP with Propofol for Lap CAPD

Haute Route - photo by JoAnn Sturman

Scott Sturman, M.D.

Bilateral subcostal TAP blocks with propofol infusion was previously described in Tricks of the Trade as a way to avoid general anesthesia for patients undergoing laparoscopic CAPD catheter insertion.  Recently one of my colleagues used this technique but employed only a left sided subcostal TAP, since the surgeon prefers to place probes in that side of the abdomen.  

I tried this technique using 30 cc of 1.5% Lidocaine and followed with a propofol infusion; it worked marvelously.  As long as the surgeon is able to work with inflation pressures less than 10 and there is no risk of aspiration, patients tolerate the procedure quite well. 

Haute Route - photo by JoAnn Sturman