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Background and Aims Abdominal aortic aneurysm (AAA) open repair surgery is one of the most highly invasive procedures, involving a large abdominal incision. In 2019, Tuglar et al. proposed a thoracoabdominal nerve block through perichondrial approach as M-TAPA block, suggesting its potential usefulness in providing analgesia over the thoracoabdominal region. However, evidence is lacking in the literature regarding its effectiveness. This study aims to evaluate the efficacy of a continuous M-TAPA block in AAA open repair surgery.

Methods Postoperative analgesia using a continuous M-TAPA block and fentanyl injection was provided in three cases of AAA open repair surgery wherein epidural anesthesia was not feasible. Postoperative pain was evaluated using a Numerical Rating Scale (NRS) and the number of patient-controlled analgesia (PCA) demands, and the range of loss of cold sensation was assessed.

Results The results are presented in the following tables. In all three cases, satisfactory analgesic effects were achieved with relatively low fentanyl PCA requirements. No adverse events associated with the continuous block were observed. There was no overlap between the surgical incision site and the puncture site for the M-TAPA block.

Conclusions This case series demonstrated the effectiveness of a continuous M-TAPA block for AAA open repair surgery. At our institution, we have recently observed increasing requests from surgeons for continuous M-TAPA block in AAA open repair surgery. This technique has the potential to shorten the time to ambulation, reduce opioid consumption, and shorten hospital stay compared to postoperative analgesia using opioids alone or single shots of peripheral nerve block.