Transversus abdominis plane block reduces postoperative pain intensity and analgesic consumption in elective cesarean delivery under general anesthesia

ArticleinJournal of Anesthesia 26(3):334-8 · February 2012with42 Reads
DOI: 10.1007/s00540-012-1336-3 · Source: PubMed
Abstract
It is reported that following abdominal surgery, transversus abdominis plane (TAP) block can reduce postoperative pain. The primary outcome of this study was the evaluation of the efficacy of TAP block on pain intensity following cesarean delivery with Pfannenstiel incision. Fifty pregnant women were randomized blindly to receive either a TAP block with 15 ml 0.25% bupivacaine in both sides (group T, n = 25) or no blockade (group C, n = 25) at the end of the surgery, which was performed with a Pfannenstiel incision under general anesthesia. The pain intensity in the patients was assessed by a blinded investigator at the time of discharge from recovery and at 6, 12, and 24 h postoperatively, with a visual analogue scale (VAS) for pain. The women in the TAP block group had significantly lower VAS pain scores at rest and during coughing and consumed significantly less tramadol than the women in group C [50 mg (0-150) vs. 250 mg (0-400), P = 0.001]. There was a significantly longer time to the first request for analgesic in the TAP block group [210 min (0-300) vs. 30 min (10-180) in group C, P = 0.0001]. Two-sided TAP block with 0.25% bupivacaine in parturients who undergo cesarean section with a Pfannenstiel incision under general anesthesia can decrease postoperative pain and analgesic consumption. The time to the first analgesic rescue was longer in the parturients who received the TAP block.
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    • "Ultrasound-guided blockade of the abdominal wall was found to be efficient for pain relief after cesarean delivery [6,7]. It is associated with a decrease of other analgesic consumption such as Tramadol [7,8] or morphine [9], and with a longer time to first analgesic request [9]. Studies have compared the analgesic efficacy of spinal morphine administration to TAP block after cesarean section. "
    [Show abstract] [Hide abstract] ABSTRACT: Background: Ultrasound-guided transversus abdominis plane block is an effective method for pain relief after cesarean delivery. The gold standard to treat pain after cesarean delivery is spinal morphine administration; at the same time TAP is considered as an effective method to treat this pain. In this study, we compared efficiency and side effects of these techniques in patients undergoing elective cesarean delivery.
    Full-text · Article · Apr 2016 · Pain Research and Treatment
    • "This study had many limitations. The 1st limitation it was not possible to limit the intramuscular spread of LA solution by the pressure of injection and incomplete separation of the fascial plane which may affect the end result of the amount of LA involved in TAP block [20]. The 2nd limitation was that the study could not eliminate the psychic factor of baby which strongly affects the mother in our locality and could encourage and motivate the mother to tolerate pain and move if male baby. "
    [Show abstract] [Hide abstract] ABSTRACT: Background: Transversus abdominis plane (TAP) block provides sensory block from T6 to L1. It is one of the most widely used regional analgesic techniques and important component of multimodal approach for postoperative analgesia in multiple lower abdominal surgeries. Objective: To compare between the analgesic potency of ropivacaine 0.2% and ropivacaine 0.5% when used in transversus abdominis plane (TAP) block for post operative analgesia after cesarean delivery. Patients and methods: Fifty parturients with American society of Anesthesiologists Physical Status I or II aged between 25 and 35. years undergoing cesarean delivery with general anesthesia were included in this prospective, randomized, double blind study. They were randomly divided into 2 groups according to the concentration of ropivacaine used in TAP block. The 1st group received bilateral 20. ml of 0.2% ropivacaine while the 2nd received the same volume of 0.5% ropivacaine at the end of the surgery. Intensity of postoperative pain at rest and during movement, time to 1st analgesic request, total dose of tramadol used, time to 1st mobilization from bed, parturients satisfaction of pain management, and complications of TAP block were recorded. Results: Visual Analogue Scale (VAS) at rest and during movement, time to 1st analgesic request, total dose of tramadol, time to 1st mobilization from bed, patients satisfaction of pain management were comparable between the two groups. Conclusion: Ropivacaine 0.2% when used in TAP block provided postoperative analgesia similar to ropivacaine 0.5% in TAP block after cesarean delivery.
    Full-text · Article · Apr 2016
    • "Upon appropriate diagnosis, patients respond very well to TAP blocks or rectus sheath blocks, usually requiring only a single injection [73, 74]. In most cases, a combination of stretching and intervention provides the best results. "
    [Show abstract] [Hide abstract] ABSTRACT: Nonobstetrical causes of pain during pregnancy are very common and can be incapacitating if not treated appropriately. Recent reports in the literature show that a significant percentage of pregnant women are treated with opioids during pregnancy. To address common pain conditions that present during pregnancy and the available pharmacological and nonpharmacological treatment options, for each of the pain conditions identified, a search using MEDLINE, PubMed, Embase, and Cochrane databases was performed. The quality of the evidence was evaluated in the context of study design. This paper is a narrative summary of the results obtained from individual reviews. There were significant disparities in the studies in terms of design, research and methodology, and outcomes analyzed. There is reasonable evidence available for pharmacological approaches; however, these are also associated with adverse events. Evidence for nonpharmacological approaches is limited and hence their efficacy is unclear, although they do appear to be primarily safe. A multimodal approach using a combination of nonpharmacological and pharmacological options to treat these pain conditions is likely to have the most benefit while limiting risk. Research trials with sound methodology and analysis of outcome data are needed.
    Full-text · Article · Oct 2015
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