Fetus delivery time in extraperitoneal versus transperitoneal cesarean section: a randomized trial

Yapça, Ömer Erkan; Topdaği, Yunus Emre; Al, Ragip Atakan

doi:10.1080/14767058.2018.1499718

Cited by 12 publications

(23 citation statements)

References 22 publications

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“…A blunt fascial opening resulted in less postoperative pain [140]. The older technique of extraperitoneal section was associated with better pain scores up to 48 h postoperatively [141]. In one study, the absence of making a bladder flap at opening the uterus resulted in clinically‐relevant improvements in postoperative pain scores [142].…”

Section: Resultsmentioning

confidence: 99%

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PROSPECT guideline for elective caesarean section: updated systematic review and procedure‐specific postoperative pain management recommendations

et al. 2020

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Caesarean section is associated with moderate-to-severe postoperative pain, which can influence postoperative recovery and patient satisfaction as well as breastfeeding success and mother-child bonding. The aim of this systematic review was to update the available literature and develop recommendations for optimal pain management after elective caesarean section under neuraxial anaesthesia. A systematic review utilising procedure-specific postoperative pain management (PROSPECT) methodology was undertaken. Randomised controlled trials published in the English language between 1 May 2014 and 22 October 2020 evaluating the effects of analgesic, anaesthetic and surgical interventions were retrieved from MEDLINE, Embase and Cochrane databases. Studies evaluating pain management for emergency or unplanned operative deliveries or caesarean section performed under general anaesthesia were excluded. A total of 145 studies met the inclusion criteria. For patients undergoing elective caesarean section performed under neuraxial anaesthesia, recommendations include intrathecal morphine 50-100 µg or diamorphine 300 µg administered pre-operatively; paracetamol; non-steroidal anti-inflammatory drugs; and intravenous dexamethasone administered after delivery. If intrathecal opioid was not administered, single-injection local anaesthetic wound infiltration; continuous wound local anaesthetic infusion; and/or fascial plane blocks such as transversus abdominis plane or quadratus lumborum blocks are recommended. The postoperative regimen should include regular paracetamol and non-steroidal anti-inflammatory drugs with opioids used for rescue. The surgical technique should include a Joel-Cohen incision; non-closure of the peritoneum; and abdominal binders. Transcutaneous electrical nerve stimulation could be used as analgesic adjunct. Some of the interventions, although effective, carry risks, and consequentially were omitted from the recommendations. Some interventions were not recommended due to insufficient, inconsistent or lack of evidence. Of note, these recommendations may not be applicable to unplanned deliveries or caesarean section performed under general anaesthesia.

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Section: Resultsmentioning

confidence: 99%

“…A total of 145 studies were included, of which 126 were randomised controlled trials and 19 were systematic reviews and meta‐analyses (Fig. 1) [9–153]. The methodological quality assessments of the 126 randomised controlled trials included in the final qualitative analysis are summarised in online Supporting Information Table S1.…”

Section: Resultsmentioning

confidence: 99%

PROSPECT guideline for elective caesarean section: updated systematic review and procedure‐specific postoperative pain management recommendations

et al. 2020

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“…It is suitable for cases where the fetus cannot be delivered from the vagina normally, such as cephalopelvic error, birth canal abnormalities, fetal distress, fetal position error, umbilical cord prolapse, history of cesarean section, multiple births, etc. ( 1 , 2 ). Placenta praevia and placental abruption are common complications of cesarean section, which can exacerbate the incidence of perinatal hemorrhage in cesarean section, and the incidence is much higher than that of natural delivery, therefore, in obstetric surgery, the blood transfusion rate of cesarean section 0.77% is higher than natural delivery 0.23% ( 3 , 4 ).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Different Blood Transfusion Methods in Patients Undergoing Cesarean Section

Guo

Tang²,

Wei³

2022

Front. Surg.

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PurposeTo compare the effect of allogeneic transfusion and acute normovolemic hemodilution (ANH) autologous transfusion in patients undergoing cesarean section.MethodsPatients who underwent cesarean section and received blood transfusion therapy from February 2019 to July 2021 in our hospital were observed and divided into the allogeneic group (n = 55) who received allogeneic transfusion therapy and the autologous group (n = 55) who received ANH autologous transfusion therapy according to the mode of transfusion. Observations included vital signs [heart rate (HR), mean arterial pressure (MAP), stroke volume variation (SVV)], blood routine [red blood cells (RBC), platelets (PLT), hematocrit (HCT), hemoglobin (Hb)], T-cell subsets (CD4+, CD8+, CD4+/CD8+), immunoglobulins (IgA, IgM, IgG), inflammatory factors [C-reactive protein (CRP), tumor necrosis factor (TNF)-α, interleukin (IL)-6], and adverse effects were counted in both groups.ResultsThere was no statistical significance in the intra-group and inter-group comparisons of HR, MAP, and SVV between the two groups before transfusion and transfusion for 10 min (P > 0.05). 5d after operation, the RBC, PLT, HCT, and Hb of the allogeneic group were lower than those before operation, and the autologous group was higher than that of the allogeneic group (P < 0.05). 5d after operation, the CRP, TNF-α, and IL-6 of the allogeneic group were higher than those before operation, and the autologous group was lower than that of the allogeneic group (P < 0.05). 5d after operation, the CD4+, CD4+/CD8+ of the allogeneic group were lower than before operation, and the CD8+ was higher than before operation. The CD4+ and CD4+/CD8+ of the autologous group were higher than that of the allogeneic group, and CD8+ was lower than that of the allogeneic group (P < 0.05). 5d after operation, the IgA, IgG, and IgM of the allogeneic group were lower than those before operation, and the autologous group was higher than that of the allogeneic group (P < 0.05). During blood transfusion, there was no significant difference in the adverse reaction rate between the two groups (P > 0.05).ConclusionBoth allogeneic transfusion and ANH autologous transfusion have little effect on the vital signs of patients undergoing cesarean section, but ANH autologous transfusion is more helpful to the stability of blood routine, T-cell subsets, immunoglobulin, and inflammation levels after surgery, which is a safe and effective way of blood transfusion.

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“…[2] Shorter surgery duration in the extraperitoneal group is consistent with the current literature. [2][3][4] We believe that the shorter surgery duration in the extraperitoneal cesarean section group may be associated with the potential reasons such as the absence of peritoneal cleaning, intestines not blocking surgical area due to spinal anesthesia, and not closing visceral and parietal peritoneum. The reason for not including the cases which underwent emergency cesarean section is the failure of providing appropriate conditions to inform the emergency cases about the technique.…”

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confidence: 98%

Reply to the Letter to the Editor: Extraperitoneal cesarean section and transperitoneal cesarean section: does extraperitoneal technique shorten the duration of surgical operation?

Yeşilbaş¹,

Erenel²

2020

Perinatal J

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Fetus delivery time in extraperitoneal versus transperitoneal cesarean section: a randomized trial

Abstract: There is no clinically significant difference between extraperitoneal cesarean section and transperitoneal cesarean on fetal delivery time. Extraperitoneal cesarean reduces postoperative pain, analgesic requirements, and improves oral tolerability.

Cited by 12 publications

References 22 publications

PROSPECT guideline for elective caesarean section: updated systematic review and procedure‐specific postoperative pain management recommendations

PROSPECT guideline for elective caesarean section: updated systematic review and procedure‐specific postoperative pain management recommendations

Comparison of Different Blood Transfusion Methods in Patients Undergoing Cesarean Section

Reply to the Letter to the Editor: Extraperitoneal cesarean section and transperitoneal cesarean section: does extraperitoneal technique shorten the duration of surgical operation?

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