Simplified table to identify overweight and obese children undergoing anesthesia

‘bulge’ was secondary to motor blockade of the regional abdominal wall muscles. The patient was discharged home without further events and was asked to return to the hospital if the bulge persisted in the first postoperative day. The patient had no issues overnight, and upon awakening the next morning, the bulge had disappeared, with no further evidence of abdominal wall motor blockade noted. During the postoperative surgical visit, the hernia repair was found to be well healed and without complication. No similar finding following TAP blockade has been previously reported in the literature. This finding is unique and anesthesiologists should be aware of especially in children with underdeveloped abdominal muscles in the setting of a TAP block performed with relatively high doses of local anesthetic. This case highlights the importance of assessing abdominal weakness in children following TAP block. Moreover, it is imperative to assure patients and parents that should motor blockade of the abdominal wall muscles occur following a TAP block, a conservative approach of reassessing the resolution of abdominal wall weakness as the block wears off is acceptable to avoid unnecessary investigations or overnight admissions.