Caesarean section wound infiltration with local anaesthesia for postoperative pain relief: any benefit?th lo

Bamigboye, Anthony Akinloye; Hofmeyr, G Justus

doi:10.7196/samj.3716

Cited by 30 publications

(29 citation statements)

References 18 publications

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“…Median postoperative length of stay was similar in both groups (6 [5]–[7] days) ( P = 0.9). Twenty seven patients in the TAP group (66%) and 19 patients (49%) in the CWI group responded to the postoperative interview.…”

Section: Resultsmentioning

confidence: 86%

“…Another meta-analysis by Bamigboye and Hofmeyr confirmed the interest of this technique after caesarean section [7].…”

Section: Discussionmentioning

confidence: 85%

“…Seeing that a single dose of local anesthetic wound infiltration only offers short-term analgesia in the postoperative period [4], a regional block or a continuous local anesthetic technique may provide better analgesia. Two recent meta-analyses have shown the efficacy of single shot bilateral Transversus Abdominis Plane (TAP) block [5], [6] after caesarean section while another demonstrated the usefulness of local anesthetic agent with Continuous Wound Infiltration (CWI) during a few days [7]. The former has been improved by ultrasound guidance [8] and the latter by placement of a multi−orifice catheter below the fascia [9].…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound-Guided Transversus Abdominis Plane Block versus Continuous Wound Infusion for Post-Caesarean Analgesia: A Randomized Trial

Chandon

Burg

et al. 2014

PLoS ONE

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ObjectiveTo compare the analgesic effect of ultrasound-guided Transversus Abdominis Plane (TAP) block versus Continuous Wound Infusion (CWI) with levobupivacaine after caesarean delivery.MethodsWe recruited parturients undergoing elective caesareans for this multicenter study. Following written informed consent, they received a spinal anaesthetic without intrathecal morphine for their caesarean section. The postoperative analgesia was randomized to either a bilateral ultrasound guided TAP block (levobupivicaine = 150 mg) or a CWI through an elastomeric pump for 48 hours (levobupivacaine = 150 mg the first day and 12.5 mg/h thereafter). Every woman received regular analgesics along with oral morphine if required. The primary outcome was comparison of the 48-hour area under the curve (AUC) pain scores. Secondary outcomes included morphine consumption, adverse events, and persistent pain one month postoperatively.ResultsRecruitment of 120 women was planned but the study was prematurely terminated due to the occurrence of generalized seizures in one patient of the TAP group. By then, 36 patients with TAP and 29 with CWI had completed the study. AUC of pain at rest and during mobilization were not significantly different: 50 [22.5–80] in TAP versus 50 [27.5–130] in CWI (P = 0.4) and 190 [130–240] versus 160 [112.5–247.5] (P = 0.5), respectively. Morphine consumption (0 [0–20] mg in the TAP group and 10 [0–32.5] mg in the CWI group (P = 0.09)) and persistent pain at one month were similar in both groups (respectively 29.6% and 26.6% (P = 0.73)).ConclusionIn cases of morphine-free spinal anesthesia for cesarean delivery, no difference between TAP block and CWI for postoperative analgesia was suggested. TAP block may induce seizures in this specific context. Consequently, such a technique after a caesarean section cannot be recommended.Trial RegistrationClinicalTrials.gov NCT01151943

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Section: Resultsmentioning

confidence: 86%

“…Another meta-analysis by Bamigboye and Hofmeyr confirmed the interest of this technique after caesarean section [7].…”

Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ultrasound-Guided Transversus Abdominis Plane Block versus Continuous Wound Infusion for Post-Caesarean Analgesia: A Randomized Trial

Chandon

Burg

et al. 2014

PLoS ONE

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“…DiVerent techniques were studied including regional analgesia and incisional-site analgesia [16][17][18]. Although CS is the most common gynecologic surgery preformed, previous studies regarding the advantages and disadvantages of the diVerent methods of anesthesia in CS deal primarily with maternal and neonatal complications [9][10][11].…”

Section: Discussionmentioning

confidence: 99%

Spinal versus general anesthesia in cesarean sections: the effects on postoperative pain perception

Kessous

Weintraub

Wiznitzer

et al. 2012

Arch Gynecol Obstet

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“…Sin embargo, los resultados han sido controversiales, desde ser beneficiosos a no presentar ninguna utilidad (18,33).…”

Section: Introductionunclassified

Infiltración con bupivacaína de la incisión de Pfannenstiel para la analgesia pos cesárea

Benítez

Machado

Zambrano

2015

Rev. chil. obstet. ginecol.

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RESUMENObjetivo: Comparar la efectividad analgésica de la infiltración con Bupivacaína de la incisión de Pfannenstiel respecto a un placebo para la analgesia posoperatoria de gestantes llevadas a cesárea segmentaria en el Hospital "Dr. Adolfo Pons" de Maracaibo, estado Zulia, Venezuela. Métodos: Investigación comparativa y aplicada, con diseño cuasi-experimental, de casos y controles, contemporáneo y de campo, donde se incluyeron 60 gestantes planificadas para cesárea segmentaria electiva, divididas aleatoriamente en dos grupos pareados para infiltrarles la incisión de Pfannenstiel con 30 mL de Bupivacaína al 0,25% (75 mg) o solución salina. La intensidad del dolor se evaluó mediante la escala visual análoga (EVA). Resultados: En cuanto a la intensidad del dolor, tanto en reposo como en movimiento, se encontraron diferencias altamente significativas a favor del grupo que recibió la infiltración incisional con Bupivacaína durante las primeras seis horas del postoperatorio (p<0,001); posterior a las 8 horas del posoperatorio no hubo diferencias significativas entre los dos grupos evaluados. De igual manera, estas pacientes presentaron un mayor tiempo libre de dolor, que sobrepasaba las 4 horas (251 ± 14 minutos vs. 220 ± 11 minutos; p<0,001), menores requerimientos analgésicos (199,37 ± 0,15 mg vs. 298,04 ± 1,96 mg; p<0,001) y con menos efectos adversos (p<0,05). Conclusión: La infiltración de la incisión de Pfannenstiel es efectiva para la analgesia postoperatoria de la cesárea segmentaria, prolongado el tiempo libre de dolor y disminuyendo los requerimientos de analgésicos.PALABRAS CLAVE: Analgesia posoperatoria, bupivacaína, cesárea, Pfannenstiel, infiltración anestésica SUMMARY Aim:To compare the analgesic effectiveness of Pfannenstiel incision infiltration with bupivacaine over a placebo for post-operative analgesia in cesarean section in pregnants attending at the Hospital "Dr. Adolfo Pons" in Maracaibo, Zulia state, Venezuela. Methods: A comparative and applied research, with quasiexperimental, case-control, contemporary and field design, which included 60 pregnant women scheduled for elective cesarean section, divided randomly into two groups matched for Pfannestiel incision infiltration with 30 mL Bupivacaine 0.25% (75 mg) or saline solution. Pain intensity was assessed by visual analog scale (VAS). Results: In terms of pain intensity at rest and in motion, were found highly significant differences in favor of the group receiving the incisional infiltration with bupivacaine during the first six hours after surgery (p<0.001); not later than 8 hours after surgery where in all measurements, were found no significant differences between the two tested groups. Similarly, these patients had higher pain free time, surpassing the 4 hours (251 ± 14 minutes vs. 220 ± 11 minutes; p<0.001), lower analgesic requirements (199.37 ± 0.15 126 REV CHIL OBSTET GINECOL 2015; 80(2): 126 -135

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Caesarean section wound infiltration with local anaesthesia for postoperative pain relief: any benefit?th lo

Cited by 30 publications

References 18 publications

Ultrasound-Guided Transversus Abdominis Plane Block versus Continuous Wound Infusion for Post-Caesarean Analgesia: A Randomized Trial

Ultrasound-Guided Transversus Abdominis Plane Block versus Continuous Wound Infusion for Post-Caesarean Analgesia: A Randomized Trial

Spinal versus general anesthesia in cesarean sections: the effects on postoperative pain perception

Infiltración con bupivacaína de la incisión de Pfannenstiel para la analgesia pos cesárea

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