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TAP block limitations — FRCA Final MCQ

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ModerateRegional AnaesthesiaTAP block limitationsFRCA Final

A 41-year-old woman is scheduled for laparoscopic ovarian cystectomy. She asks whether a bilateral transversus abdominis plane block could be the sole anaesthetic technique. The surgeon expects visceral traction and pneumoperitoneum. What is the most appropriate anaesthetic technique?

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Correct answer: B — General anaesthesia with TAP block as part of multimodal analgesia

A TAP block provides somatic abdominal wall analgesia but does not cover visceral pain from pneumoperitoneum and pelvic traction. It can be useful as part of multimodal postoperative analgesia. Rectus sheath and lumbar plexus blocks do not provide reliable anaesthesia for laparoscopic pelvic surgery. Matching block anatomy to surgical pain mechanisms is a core regional anaesthesia principle.

Reference: RA-UK regional anaesthesia guidance; RCoA Final FRCA Syllabus 2026