How I Do It: Transversalis Fascia Plane Block
The transversalis fascia plane (TFP) block is an ultrasound-guided abdominal wall block involving injection of local anesthetic into the plane between the transversus abdominis muscle (TAM) and the deeper investing transversalis fascia.1,2 The injection point is immediately superior to the iliac crest and close to where the posterior edge of internal oblique muscle (IOM) and TAM meet the quadratus lumborum muscle (QLM). The TFP block targets the ilioinguinal and iliohypogastric nerves at a proximal location along their course and provides analgesia in the territory of their branches (Figure 1). Clinical applications include treatment of acute pain after anterior iliac crest bone graft harvesting2, inguinal herniorraphy3-6, caesarean section7-10; and management of chronic post-herniorraphy pain.11
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