Oblique sub‐costal transversus abdominis plane (TAP) catheters: an alternative to epidural analgesia after upper abdominal surgery

Summary The authors present three cases where catheters placed in the oblique sub‐costal transversus abdominis plane provided prolonged analgesia after upper abdominal surgery. Patient 1 was admitted with severe sepsis following major hepatobiliary surgery. Bilateral catheters facilitated weaning from mechanical ventilation and provided adequate analgesia for 4 days. Patient 2 underwent emergency laparotomy for intestinal obstruction having refused consent for epidural analgesia. The transversus abdominis plane catheters provided a significant opioid sparing effect. A unilateral catheter offered rescue analgesia in patient 3 when the epidural catheter was displaced. We put forward a case for oblique sub‐costal transversus abdominis plane catheters as an alternative to epidural analgesia after upper abdominal surgery.