The Analgesic Efficacy of Transversus Abdominis Plane Block After Cesarean Delivery: A Randomized Controlled Trial

McDonnell, John G.; Curley, Gerard F.; Carney, John; Benton, Aoife; Costello, J; Maharaj, Chris; Laffey, John G.

doi:10.1213/01.ane.0000290294.64090.f3

Cited by 556 publications

(343 citation statements)

References 6 publications

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“…12,14 In line with the above reports, we found a significant difference in the score 1 sedation (34.5% vs. 11.5%, p = 0.01) in favour of the TAP group. Relevant differences in pruritus were not found as there was only one patient who developed score 1 (mild) pruritus from the control group (Table 2).…”

Section: Discussionsupporting

confidence: 88%

“…11,13,14 There are different possible explanations: in Orotta Maternity National Referral Hospital pain management is in an early state; no standard labour and post-Caesarean section pain management protocols exist. No analgesia is administered for labour pain, and clinicians rarely try to manage post-Caesarean section pain using diclofenac intramuscularly (IM) unless mothers complain of severe pain.…”

Section: Discussionmentioning

confidence: 99%

“…7,[11][12][13][14] In these cases, the opioid requirement was determined by calculating the amount of morphine consumed at a particular time depending on the patient's needs, no matter how severe the pain. On the other hand, PCA is not available in many of the low-income countries.…”

Section: Discussionmentioning

confidence: 99%

“…4 Other studies confirmed the effectiveness after Caesarean section with lower pain scores, less opioid requirement and thereby fewer side effects. 11,[13][14][15] Even though the effect of TAP block as multimodal analgesia has been confirmed in different randomised clinical trials, 11,[13][14][15][16][17] whether posterior and lateral approach TAP block have differences in efficacy and duration of analgesic effect has remained controversial. However, in one meta-analysis study, the posterior TAP block technique appeared to have more prolonged analgesia effect than the lateral TAP block in lower abdominal significant (nausea 5.8% vs. 1.9%, p = 0.45 and vomiting 7.7% vs. 0%, p = 0.06) (see Table 2).…”

Section: Discussionmentioning

confidence: 99%

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Transversus abdominis plane block after Caesarean section in an area with limited resources

Kahsay

Elsholz

Bahta

2017

Southern African Journal of Anaesthesia and Analgesia

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Background:The primary objective of this study was to assess whether transversus abdominis plane (TAP) block is effective as part of multimodal pain management following Caesarean section in an area with limited resources. The study also looked at the advantage of this block in reducing the consumption of morphine and diclofenac postoperatively. Methods: After approval by the institutional ethics committee and informed consent of participants, 108 ASA I and II patients for Caesarean section under spinal anaesthesia were randomly allocated to either the TAP block group or the control. The TAP block group received a landmark-orientated, bilateral TAP block in the triangle of Petit. Postoperative pain treatment followed the same protocol for both groups. Visual analogue scale (VAS) pain scores were measured at 2, 4, 6, 8, 12, 18 and 24 h postoperatively. At the same time, consumption of diclofenac and morphine was measured and compared. Results: No adverse effects of the TAP block were detected. VAS pain scores were significantly lower in the TAP block group at rest, deep breathing, intentional coughing, and mobilisation in all cases (p < 0. 05). Morphine and diclofenac consumption was significantly higher in the control group (p < 0. 001). Conclusion: TAP block reduced the VAS pain scores significantly both at rest and during stressors. As a result, morphine and diclofenac consumption was significantly reduced in the TAP block group. Therefore, it is feasible to implement TAP block as part of a multimodal analgesia regimen after Caesarean section in a tertiary health care centre in a developing nation.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Transversus abdominis plane block after Caesarean section in an area with limited resources

Kahsay

Elsholz

Bahta

2017

Southern African Journal of Anaesthesia and Analgesia

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“…In contrast, the evaluation of pain intensity for a period of 48 hours after a C-section, was conducted among some authors after applying TAPB,; and by Blanco at al. after application of QLB II [14,18,25]. One of the main methods of assessing the effectiveness of analgesic QLB I was to compare the use of morphine for patients in two study groups [11,14].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the effectiveness of the Quadratus Lumborum Block type I using ropivacaine in postoperative analgesia after a cesarean section — a controlled clinical study

et al. 2018

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Objectives: Quadratus Lumborum Block in contrast to Transversus Abdominis Plane Block contains a unique component which not only stops somatic pain but also inhibits visceral pain by spreading the local anesthetic to the paravertebral space. This study was designed to determine whether performing the Quadratus Lumborum Block type I in patients undergoing cesarean section would be associated with both decreased morphine consumption and decreased pain levels in the postoperative 48-hour period. Material and methods:Sixty patients undergoing caesarean section under spinal anesthesia were randomly and equally assigned to one or other of two groups: QLB I (who received Bilateral Quadratus Lumborum Block type I with the use of 24 mL 0.375% ropivacaine per side) or a Control group. In both groups, on-demand morphine analgesia was administered postoperatively within the first 48 hours. The following were measured: the morphine consumption; the time elapsed from the C-section until the first dose of morphine; and the levels of pain intensity among patients in rest (numeral pain rating scale).Results: There were no statistically significant demographic data differences between the QLB I and Control groups. The following significant differences were observed in the 48-hour postoperative period: morphine consumption was higher in the Control group (p = 0.000); the time elapsed from the C-section until the first dose of morphine was longer in QLB I group (p < 0.05); and the median of the pain numeric rating scale was higher in the Control group (p < 0.05). Conclusions:Quadratus Lumborum Block type I significantly reduces morphine consumption and pain levels up to 48 hours postoperatively.

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Local anaesthetic wound infiltration and abdominal nerves block during caesarean section for postoperative pain relief

Bamigboye¹,

Hofmeyr

2009

Cochrane Database of Systematic Reviews

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The Analgesic Efficacy of Transversus Abdominis Plane Block After Cesarean Delivery: A Randomized Controlled Trial

Abstract: The TAP block, as a component of a multimodal analgesic regimen, provided superior analgesia when compared with placebo block up to 48 postoperative hours after elective cesarean delivery.

Cited by 556 publications

References 6 publications

Transversus abdominis plane block after Caesarean section in an area with limited resources

Transversus abdominis plane block after Caesarean section in an area with limited resources

Evaluation of the effectiveness of the Quadratus Lumborum Block type I using ropivacaine in postoperative analgesia after a cesarean section — a controlled clinical study

Local anaesthetic wound infiltration and abdominal nerves block during caesarean section for postoperative pain relief

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