Surgeon-delivered non-ultrasound-guided TAP blocks enhance recovery in DIEP flap breast reconstruction: A…

Cohort studyJournal of plastic, reconstructive & aesthetic surgery : JPRAS· May 2026

Surgeon-delivered non-ultrasound-guided TAP blocks enhance recovery in DIEP flap breast reconstruction: A prospective comparative cohort study.

Shane Cullen, Sameh Hashem, Eimear Phoenix … Colin Morrison

Pain MedicineCohort studyTreatmentQ1IF 1.9

Surgeon-delivered transversus abdominis plane blocks associated with lower day-0 pain after deep inferior epigastric perforator flap surgery

Surgeon-delivered non-ultrasound-guided TAP blocks enhance recovery in DIEP flap breast reconstruction: A prospective comparative cohort study.

Shane Cullen … Colin Morrison

Journal of plastic, reconstructive & aesthetic surgery · May 2026

Background

Donor-site pain remains a major barrier to early recovery after deep inferior epigastric perforator (deep inferior epigastric perforator) flap breast reconstruction, despite advances in enhanced recovery after surgery (enhanced recovery after surgery) pathways.

Methods

A prospective comparative cohort study was conducted by including 88 patients undergoing immediate deep inferior epigastric perforator flap reconstruction after mastectomy.

n = 88 patients

Results

Transversus abdominis plane block patients had lower pain scores the day of surgery

4.08pain s

Control

2.78pain s

TAP block

More results

Similar results were reported on postoperative days 1 and 2.

Transversus abdominis plane patients required fewer patient-controlled analgesia doses on day 0 following surgery (10.3±5.52 vs 21±8.6, p<0.002).

Postoperative days 1 and 2 showed similar effects.

More results

Independent mobilisation occurred earlier (mean 2.0 vs 3.5 days, p<0.001), and opiate-related side effects particularly nausea and constipation were significantly reduced.

“

Conclusion · 1 of 2

A single-dose, surgeon-delivered, non-ultrasound guided transversus abdominis plane blocks provide effective, opioid-sparing analgesia and enhances recovery following deep inferior epigastric perforator flap reconstruction.

Conclusion · 2 of 2

This simple, reproducible and cost-effective technique offers surgeons direct control of postoperative analgesia and represents a valuable addition to enhanced recovery after surgery pathways. Randomised trials are now warranted.

Surgeon-delivered non-ultrasound-guided TAP blocks enhance recovery in DIEP flap breast reconstruction: A prospective comparative cohort study.

Surgeon-delivered non-ultrasound-guided TAP blocks enhance recovery in DIEP flap breast reconstruction: A prospective comparative cohort study.

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