Transversus abdominis plane block reduces postoperative pain intensity and analgesic consumption in elective cesarean delivery under general anesthesia

Eslamian, L.; Jalili, Zorvan; Jamal, Ashraf; Marsoosi, V.; Movafegh, Ali

doi:10.1007/s00540-012-1336-3

Cited by 93 publications

(82 citation statements)

References 21 publications

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“…In our study of a Control group and the QLB I group, the median of the total morphine dose administered subcutaneously in the first 24 hours was 20mg and 10mg respectively; and during the first 48 hours 30 mg and 15 mg respectively. This result compares with other authors' studies which evaluated morphine consumption by PCA iv during the first 24 hours, where performing the QLB II or TAPB had results of 7.5 mg, 18 mg, 19 mg and 25 mg across the different studies [14,21,22,26].…”

Section: Discussionsupporting

confidence: 47%

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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Section: Discussionsupporting

confidence: 47%

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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“…All the studies reported the 24-hr pain score, and 11 trials documented the 24-hr morphine consumption. 22,24,27,29,34,35,44,46,47,56,57 Transversus abdominal plane block did not significantly reduce the pain score (Table 2) at 24 hr but significantly reduced the mean 24-hr opioid consumption by 10 mg (95% CI, -17.4 to -2.8; P = 0.006) compared with the control group ( Table 2). The US-guided and landmark subgroup analyses for Cesarean delivery studies are presented in Table 3.…”

Section: Transversus Abdominal Plane Block Vs Local Infiltrationmentioning

confidence: 94%

Transversus abdominal plane block for postoperative analgesia: a systematic review and meta-analysis of randomized-controlled trials

Brogi

Kazan

Cyr

et al. 2016

Can J Anesth/J Can Anesth

133

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Purpose The transversus abdominal plane (TAP) block has been described as an effective pain control technique after abdominal surgery. We performed a systematic review and meta-analysis of randomized-controlled trials (RCTs) to account for the increasing number of TAP block studies appearing in the literature. The primary outcome we examined was the effect of TAP block on the postoperative pain score at six, 12, and 24 hr. The secondary outcome was 24-hr morphine consumption. Source We searched the United States National Library of Medicine database, the Excerpta Medica database, and the Cochrane Central Register of Controlled Clinical Studies and identified RCTs focusing on the analgesic efficacy of TAP block compared with a control group [i.e., placebo, epidural analgesia, intrathecal morphine (ITM), and ilioinguinal nerve block after abdominal surgery]. Meta-analyses were performed on postoperative pain scores at rest at six, 12, and 24 hr (visual analogue scale, 0-10) and on 24-hr opioid consumption. Principal findings In the 51 trials identified, compared with placebo, TAP block reduced the VAS for pain at six hours by 1.4 (95% confidence interval [CI], -1.9 to -0.8; P\0.001), at 12 hr by 2.0 (95% CI, -2.7 to -1.4; P\0.001), and at 24 hr by 1.2 (95% CI, -1.6 to -0.8; P \ 0.001). Similarly, compared with placebo, TAP block reduced morphine consumption at 24 hr after surgery (mean difference, -14.7 mg; 95% CI, -18.4 to -11.0; P \0.001). We observed this reduction in pain scores and morphine consumption in the TAP block group after gynecological surgery, appendectomy, inguinal surgery, bariatric surgery, and urological surgery. Nevertheless, separate analysis of the studies comparing ITM with TAP block revealed that ITM seemed to have a greater analgesic efficacy. Conclusions The TAP block can play an important role in the management of pain after abdominal surgery by reducing both pain scores and 24-hr morphine consumption. It may have particular utility when neuraxial techniques or opioids are contraindicated. RésuméObjectif Le bloc dans le plan du muscle transverse de l'abdomen (ou TAP bloc) a été décrit comme une technique efficace de contrô le de la douleur après une chirurgie abdominale. Nous avons réalisé une revue systématique et une méta-analyse des études randomisées contrô lées (ERC) pour faire un état des lieux du nombre croissant d'études

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“…Another study conducted after cesarean delivery found that TAP group had reduced pain score and total morphine consumption in the first 48 postoperative hours [13]. The same promising results were also obtained on patients undergoing prostatectomy [7], appendectomy, cesarean section [16][17][18], colorectal resections [19] and total abdominal hysterectomy [14]. In contrary, the block does not provide additional benefit to multimodal analgesia in gynecological cancer surgery [20].…”

Section: Introductionmentioning

confidence: 85%

“…Accordingly, TAP block reduced the severity of postoperative pain in the first 24 postoperative hours by more than 70% as measured by VAS compared to the Non-TAPs. Studies conducted on patients undergoing abdominal surgery [6], total abdominal hysterectomy [14] and cesarean delivery showed a comparable reduction in the VAS of TAP group [13,17].…”

Section: /5mentioning

confidence: 94%

Trans Abdominis Plan Block Reduce Postoperative Analgesic Requirement and Prolong Time to First Analgesic Request in Abdominal Surgery at University of Gondar Hospital: Prospective Observational Study

2015

JACCOA

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Background: Poorly controlled pain after abdominal surgery is associated with patient suffering and prolonged hospital stay. The increasing use of Transverse abdominis plan block (TAP), as a form of pain relief after abdominal surgery warrants evaluation of its effectiveness as an adjunctive technique to routine care and, when compared with other analgesic techniques. This observational study evaluated the efficacy of blindly performed TAP block after abdominal surgeries.

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Transversus abdominis plane block reduces postoperative pain intensity and analgesic consumption in elective cesarean delivery under general anesthesia

Cited by 93 publications

References 21 publications

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

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

Transversus abdominal plane block for postoperative analgesia: a systematic review and meta-analysis of randomized-controlled trials

Trans Abdominis Plan Block Reduce Postoperative Analgesic Requirement and Prolong Time to First Analgesic Request in Abdominal Surgery at University of Gondar Hospital: Prospective Observational Study

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