Table 3.

Advantages and disadvantages of TLA

Advantages	Hydrodissection effect
	The addition of epinephrine results in less intraoperative bleeding
	The slow infiltration, pressure buildup, and marked lipophilicity of LA, together with vasoconstrictors, result in a prolonged effect of TLA
	The long-lasting anesthetic effect leads to a reduction in postoperative pain
	Ease of administration—compared to epidural, intercostal block and paravertebral block, TLA is very resource efficient and does not require individuals with special skills
	Local anesthetics also have antimicrobial activity [28]
Disadvantages	Moist surgical site
	Time-consuming infiltration
	Guidance of the awake patient
	Possible intraoperative pain with necessary additional analgesia
	(Low) risk of intravascular application of TLA solution