Assessment of the analgesic potency of ropivacaine 0.2% versus ropivacaine 0.5% in transversus abdominis plane block after cesarean delivery

Abstract

To cite this article: Ahmed Zein El Abdein Mohamed (2016) Assessment of the analgesic potency of ropivacaine 0.2% versus ropivacaine 0.5% in transversus abdominis plane block after cesarean deliveryAbstract 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.

Efficacy of Nalbuphine with Flurbiprofen on Multimodal Analgesia with Transverse Abdominis Plane Block in Elderly Patients Undergoing Open Gastrointestinal Surgery: A Randomized, Controlled, Double-Blinded Trial

“…A meta-analysis indicated that compared with alternative analgesic techniques, epidural analgesia did not provide additional clinical benefits to patients during laparoscopic colorectal surgery [ 24 ]. TAPB is a novel and effective analgesia for controlling postoperative pain, and it can provide somatic anesthesia for abdominal surgeries [ 25 – 29 ]. It is important to note that the shortcoming of a single injection of local anesthetic is the limited time of regional neural blockade [ 30 ].…”

Comparative evaluation of ropivacaine and ropivacaine with dexamethasone in transverse abdominis plane block for lower abdominal surgeries: a prospective, randomized, double-blinded study

“…who showed that ropivacaine 0.2% produces similar analgesia compared to 0.5% in TAP block for cesarean sections done under general anesthesia. [ 10 ]…”

“…Peripheral nerve blocks require minimum concentration of local anesthetics. [ 10 ] Due to the enhanced sensory blockade and less toxic profile of ropivacaine compared to bupivacaine, 0.25% ropivacaine was chosen for the study. There were also variations in the pain scores with the dose of local anesthetics and dexamethasone used in the previous studies.…”

Effect of Dexamethasone as an Additive to Ropivacaine on Duration of Ultrasound Guided Transversus Abdominis Plane Block in Cesarean Section under Spinal Anesthesia

“…10 In a study conducted by Ahmed Z EL there was no significant difference in analgesic potency between ropivacaine 0.25% and 0.5% concentration. 11 Study conducted by De Oliveira et. al.…”