Analgesia Effect of Ultrasound-Guided Transversus Abdominis Plane Block Combined with Intravenous Analgesia After Cesarean Section: A Double-Blind Controlled Trial

Abstract

Introduction Complete postoperative analgesia is very important for puerperae after cesarean section. The objective of this study was to explore the optimal postoperative analgesia after cesarean section. Methods A total of 180 full-term puerperae who underwent cesarean section in Hanzhong People's Hospital from March 2019 to March 2020 were enrolled and were randomly divided into three groups. Group A was given 0.9% normal saline, group B and C were given 0.4% ropivacaine for transversus abdominis plane block (TAPB). Postoperative patient-controlled intravenous analgesia (PCIA) pumps were 2 μg/kg sufentanil + 2.5 mg droperidol, 1.5 μg/kg and 1.3 μg/kg sufentanil, respectively. All puerperae were given different but effective analgesia programs. The primary outcome indicators were visual analog scores (VAS), the first compression time of postoperative analgesia pump and the total number of compressions in 48 h. The secondary outcome indicators were vital signs, Ramsay sedation scores, comfort scores (BCS), the frequency of analgesic rescue, postoperative side effects and satisfaction. Results The dynamic and static VAS scores of the puerperae in group B at T 2 and T 6 were significantly lower than group A and at T 12 , T 24 and T 48 were significantly lower than group C. Compared with group A, the dynamic and static VAS scores of puerperae in group C were lower at T 2 and T 6 and higher at T 12 , T 24 and T 48 . The Ramsay score and BCS score of the puerperae in group C at T 12 , T 24 and T 48 were significantly lower than those in groups A and B. Conclusions PCIA with sufentanil alone or combined with TAPB can be safely and effectively used for postoperative analgesia after cesarean section. PCIA combined with TAPB had better analgesic effect and lower incidence of side effects while reducing the dose of opioids. The results of this study provide new ideas and insights for the choice of analgesia after cesarean section.

Patient‐controlled intravenous administration of dexmedetomidine with nalbuphine versus sufentanil for post cesarean delivery analgesia: A retrospective observational study

“…The worst pain intensity was observed within 48 h after cesarean delivery, mainly including incision pain and visceral pain 34 . In this retrospective study, the primary outcome was the postoperative pain intensity, being consistent with other previous studies 35,36 . NAL is a nonscheduled κ opioid receptor agonist, and the analgesic effect of activating peripheral κ‐receptors was reported to be closely associated with visceral pain, which could be further strengthened by high levels of estrogen and progesterone in puerperae 37 .…”

“…34 In this retrospective study, the primary outcome was the postoperative pain intensity, being consistent with other previous studies. 35,36 NAL is a nonscheduled κ opioid receptor agonist, and the analgesic effect of activating peripheral κ-receptors was reported to be closely associated with visceral pain, which could be further strengthened by high levels of estrogen and progesterone in puerperae. 37 We first found that the visceral pain at rest and at mobilization at T2-T24 after surgery was significantly alleviated in the Group II as compared with the Group I, with no difference in the level of sedation and incision pain within 48 h after surgery.…”

Response to Letter to the Editor Regarding “Analgesia Effect of Ultrasound-Guided Transversus Abdominis Plane Block Combined with Intravenous Analgesia After Cesarean Section: A Double-Blind Controlled Trial”

“…We are very grateful to Li et al for their interest in our recent publication of ''Analgesia Effect of Ultrasound-Guided Transversus Abdominis Plane Block Combined with Intravenous Analgesia After Cesarean Section: A Double-Blind Controlled Trial'' [1]. They also put forward meaningful questions.…”

Letter to the Editor Regarding “Analgesia Effect of Ultrasound-Guided Transversus Abdominis Plane Block Combined with Intravenous Analgesia After Cesarean Section: A Double-Blind Controlled Trial”

“…In a single-center randomized controlled trial with a double-blind design and a total of 180 full-term puerperae undergoing cesarean section, Xue et al [ 1 ] assessed postoperative analgesic efficacy of ultrasound-guided transversus abdominis plane block (UGTAPB) combined with patient-controlled intravenous analgesia (PCIA) by comparing to PCIA alone. They showed that PCIA or PCIA combined with UGTAPB could provide safe and effective analgesia, but PCIA combined with UGTAPB was better in analgesic effect with a lower incidence of side effects and reduced opioid consumption.…”