Linea Semilunaris vs. Lateral Transversus Abdominis Plane (TAP) Block after Caesarean Section: A Narrative Review
DOI:
https://doi.org/10.24843/qg4fmv98Keywords:
Anesthesia, Local, Cesarean Section, Enhanced Recovery After Surgery, Postoperative Pain, Visual Analog ScaleAbstract
Cesarean section (CS) is a major obstetric surgery with a prevalence of moderate to severe postoperative pain exceeding 80% within the first 24 hours. Pain involves both somatic and visceral components, and inadequate pain management may impair early mobilization, hinder breastfeeding, increase the risk of postpartum depression, and contribute to chronic pain. The Transversus Abdominis Plane (TAP) block is an effective regional analgesia technique that can reduce somatic pain after CS and decrease opioid requirements. Two commonly used approaches are the linea semilunaris and lateral approaches; however, direct comparisons of their effectiveness in CS patients remain scarce in Indonesia. This narrative review was conducted through a literature search between 2015 and 2025 and included clinical studies evaluating pain intensity, analgesia duration, opioid requirements, and adverse effects in post-CS patients. The results show that linea semilunaris may offer broader analgesic coverage and longer duration of analgesia compared to the lateral approach in post-CS patients. Large-scale, well-designed RCTs are needed to confirm its clinical superiority and establish optimal dosing guidelines.
Downloads
References
1. Vrooman BM, Youngren KM. Chronic pain management. In: Butterworth JF IV, Mackey DC, Wasnick JD, editors. Morgan & Mikhail’s Clinical Anesthesiology. 7th ed. New York: McGraw-Hill Education; 2022. p. 1069-1134.
2. Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S, et al. The revised International Association for the Study of Pain definition of pain: concepts, challenges, and compromises. Pain. 2020 Sep 1;161(9):1976–82. doi:10.1097/j.pain.0000000000001939
3. Tsai HC, Yoshida T, Chuang TY, Yang SF, Chang CC, Yao HY, et al. Transversus Abdominis Plane Block: An Updated Review of Anatomy and Techniques. Biomed Res Int. 2017 Jan 1;2017(1):8284363. doi:10.1155/2017/8284363
4. Tran DQ, Bravo D, Leurcharusmee P, Neal JM. Transversus abdominis plane block: A narrative review. Anesthesiology. 2019 Nov 1;131(5): 1166–90. doi:10.1097/ALN.0000000000002842
5. John M, Guys IA, Thomas’ Nhs S. TAP block nomenclature. Anaesthesia. 2015 Jan 1;70(1):112–3. doi:10.1111/anae.12970
6. Mallan D, Sharan S, Saxena S, Singh TK, Faisal. Anesthetic techniques: focus on transversus abdominis plane (TAP) blocks. Local Reg Anesth. 2019 Sep 5;12:81–8. doi:10.2147/LRA.S138537
7. Xu C, Wang Z, Wang C, Lu J, Zhou Q. Effectiveness and safety of new umbilical paramedian semilunaris approach for transverse abdominis plane block: a prospective, single-arm, observational, evaluation study. Quant Imaging Med Surg. 2023 Jul 1;13(7):4641–7. doi:10.21037/qims-23-245
8. Faiz SHR, Alebouyeh MR, Derakhshan P, Imani F, Rahimzadeh P, Ashtiani MG. Comparison of ultrasound-guided posterior transversus abdominis plane block and lateral transversus abdominis plane block for postoperative pain management in patients undergoing cesarean section: a randomized double-blind clinical trial study. J Pain Res. 2017 Dec 19;11:5–9. doi:10.2147/JPR.S146970
9. Uppal V, Sancheti S, Kalagara H. Transversus Abdominis Plane (TAP) and Rectus Sheath Blocks: a Technical Description and Evidence Review. Curr Anesthesiol Rep. 2019 Dec 1;9(4):479–87. doi:10.1007/s40140-019-00351-y
10. Sun N, Wang S, Ma P, Liu S, Shao A, Xiong L. Postoperative analgesia by a transversus abdominis plane block using different concentrations of ropivacaine for abdominal surgery a meta-analysis. Clinical Journal of Pain. 2016 Dec 19; 33(9): 853–63. doi:10.1097/AJP.0000000000000468
11.Sahu S, Sayeed Z, Singh TK, Srivastava D, Aneesh, Bhadauria D. Comparison of Analgesic Efficacy of Ropivacaine and Levobupivacaine in Ultrasound-Guided Transversus Abdominis Plane Block and Port Site Infiltration in Laparoscopic Live-Donor Nephrectomy, a Double-Blind Randomized Parallel Group Trial. Bali Journal of Aneshtesiology. 2020 Oct; 4(4): 188-193. doi: 10.4103/BJOA.BJOA_157_2
Downloads
Published
Data Availability Statement
No new data were generated or analysed in this study.
Issue
Section
License
Copyright (c) 2026 Luh Ratna Oka Rastini, Putu Kurniyanta (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal the right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC BY 4.0) that allows others to share, use, distribute, and reproduce the work in any medium, provided the original author and source are properly credited.
