Postoperative analgesia after caesarean section with transversus abdominis plane block or continuous infiltration wound catheter: A randomized clinical trial. TAP vs. infiltration after caesarean section

Klasen, Fanny; Bourgoin, A; Antonini, François; Dazeas, Emma; Bretelle, Florence; Martin, Claude; Baumstarck, Karine; Léone, Marc

doi:10.1016/j.accpm.2016.02.006

Cited by 27 publications

(22 citation statements)

References 31 publications

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“…Certainly, in some particular settings, such as pediatric surgery or cesarean section, CWI has widely demonstrated its advantages both with respect to neuraxial analgesia than other techniques, guaranteeing excellent outcomes in terms of postoperative pain control, opioid demand, ease of execution, side effects. [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58] Regarding laparoscopic surgery, among 13 articles retrieved [59][60][61][62][63][64][65][66][67][68][69][70][71] most were related to laparoscopic colorectal surgery (9 out of 13). [59][60][61][63][64][65]67,69,71 Similar to what has been demonstrated for open abdominal surgery, also in this case, CWI has demonstrated its effectiveness in the postoperative pain control, parental opioid consumption, rate of nausea/vomiting, early mobilization, bowel and pulmonary function; both when this technique has been compared with systemic or epidural analgesia.…”

Section: Lower Limb Surgerymentioning

confidence: 99%

<p>Continuous Wound Infiltration of Local Anesthetics in Postoperative Pain Management: Safety, Efficacy and Current Perspectives</p>

Paladini

Carlo

Musella

et al. 2020

JPR

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Local infiltration and continuous infusion of surgical wound with anesthetics are parts of multimodal analgesia for postoperative pain control. The techniques, given the simplicity of execution that does not increase the timing of the intervention and does not require additional technical skills, are applied in several kinds of surgeries. The continuous wound infiltration can be used for days and a variety of continuous delivery methods can be chosen, including patientcontrolled analgesia, continuous infusion or intermittent bolus. The purpose of this narrative review is to analyze the literature, in particular by researching the safety, efficacy and current perspectives of continuous wound infiltration for postoperative pain management in different surgical settings. We have identified 203 articles and 95 of these have been taken into consideration: 17 for the lower limb surgery; 7 for the upper limb surgery, 51 for the laparotomy/ laparoscopic surgery of the abdominopelvic area, 13 studies regarding breast surgery and 7 for cardiothoracic surgery. The analysis of these studies reveals that the technique has a variable effectiveness based on the type of structure involved: it is better in structures rich in subcutaneous and connective tissue, while the effectiveness is limited in anatomic districts with a greater variability of innervation. However, regardless the heterogeneity of results, a general reduction in pain intensity and in opioid consumption has been observed with continuous wound infiltration: it is an excellent analgesic technique that can be included in the multimodal treatment of postoperative pain or represents a valid alternative when other options are contraindicated.

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Section: Lower Limb Surgerymentioning

confidence: 99%

<p>Continuous Wound Infiltration of Local Anesthetics in Postoperative Pain Management: Safety, Efficacy and Current Perspectives</p>

Paladini

Carlo

Musella

et al. 2020

JPR

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“…Four studies 20–23 reported the level of sedation of the patient. The risk of mild or moderate sedation after post‐CS administration of wound infiltration of TAP block was not different between groups (RR 1.12, 95% CI 0.72–1.74, I 2 = 49%) (Figure 4c).…”

Section: Resultsmentioning

confidence: 99%

Transversus abdominis plane block versus wound infiltration for post‐cesarean section analgesia: A systematic review and meta‐analysis of randomized controlled trials

Riemma

Schiattarella

Cianci

et al. 2021

Intl J Gynecology & Obste

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Background Transversus abdominis plane (TAP) block and wound infiltration (WI) with local anesthetics are used for postoperative analgesia after cesarean section (CS), reducing the need for administration of opioids. Objective To compare the analgesic effect of TAP block related to WI. Search strategy MEDLINE, Scopus, ClinicalTrials.gov, EMBASE, Cochrane Library, and CINAHL were searched from inception until April 2020. Selection criteria Randomized controlled trials (RCTs) about women who underwent TAP block or WI after CS. Data collection and analysis Relevant data were extracted and tabulated. Review Manager 5.3 was used for data analysis. Primary outcome was cumulative opioid consumption (COC) 24 and 48 h after CS. Main results Five RCTs, enrolling 268 women, were included. There were no significant differences between the interventions regarding COC at 24 (mean difference [MD] –1.68, 95% confidence interval [CI] –6.29 to 2.93) and 48 hours (MD 1.28, 95% CI –10.44 to 13.00). Adverse effects (relative risk [RR] 0.93, 95% CI 0.75–1.16), gastrointestinal reactions (RR 1.30, 95% CI 0.46–3.68), or mild‐moderate sedation (RR 1.12, 95% CI 0.72–1.74), pain scores, satisfaction of women, and withdrawals were similar between groups. Conclusions There might be no significant advantages selecting TAP block over WI for post‐CS analgesia.

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“…Die Datenlage zum analgetischen Nutzen der TAP-Blockade zur Schmerztherapie nach Sectio ist inkonsistent. Vergleicht man prospektiv randomisiert die Wundinfiltration mittels Katheter (Ropivacain 0,2 % 10 ml Bolus + 5 ml/h über 48 h) mit einem TAP-Block (1,5 mg/kg Ropivacain 0,75 %), so zeigen aktuelle Studiendaten keinen Unterschied im begleitenden kumulativen Opioid-Schmerzmittelverbrauch, in der Schmerzintensität, in der Zufriedenheit der Patientin oder in dem Auftreten von Nebenwirkungen zwischen den beiden Verfahren [43]. Offensichtlich besteht ein analgetischer Effekt hinsichtlich des Wundschmerzes, hingegen bleibt der viszerale Schmerz weiter bestehen [44].…”

Section: Tap-blockunclassified

Geburtshilfliche Anästhesie Teil 2: Etablierte Standards und neue Perspektiven

Kranke¹,

Annecke²,

Bremerich³

et al. 2018

Frauenheilkunde up2date

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Postoperative analgesia after caesarean section with transversus abdominis plane block or continuous infiltration wound catheter: A randomized clinical trial. TAP vs. infiltration after caesarean section

Cited by 27 publications

References 31 publications

<p>Continuous Wound Infiltration of Local Anesthetics in Postoperative Pain Management: Safety, Efficacy and Current Perspectives</p>

<p>Continuous Wound Infiltration of Local Anesthetics in Postoperative Pain Management: Safety, Efficacy and Current Perspectives</p>

Transversus abdominis plane block versus wound infiltration for post‐cesarean section analgesia: A systematic review and meta‐analysis of randomized controlled trials

Geburtshilfliche Anästhesie Teil 2: Etablierte Standards und neue Perspektiven

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