ABSTRACT
Anaesthesia for abdominal surgery embraces a wide range of disciplines. In many cases, the technique of choice involves general anaesthesia, perhaps in combination with thoracic epidural anaesthesia for postoperative pain relief. Not all intra-abdominal procedures necessitate general anaesthesia. Those confi ned to the pelvis are frequently carried out under spinal anaesthesia or epidural blockade. Some body surface procedures are adequately carried out using local nerve blocks or infi ltration anaesthesia. Inguinal hernia repair falls into this category. Much lower abdominal surgery is performed under a regional block alone – spinal or combined epidural-spinal anaesthesia – or using a regional technique as an adjunct to light general anaesthesia. The more widespread availability of highquality bedside ultrasound has encouraged increasing use of both single-shot and continuous catheter regional blocks as an alternative to the thoracic epidural. The transversus abdominis plane (TAP) block has emerged as the leading technique in this group, although rectus sheath and other blocks also have a role.
