Skip to main content
Erschienen in: Journal of Anesthesia 3/2012

01.06.2012 | Original Article

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

verfasst von: Laleh Eslamian, Zorvan Jalili, Ashraf Jamal, Vajiheh Marsoosi, Ali Movafegh

Erschienen in: Journal of Anesthesia | Ausgabe 3/2012

Einloggen, um Zugang zu erhalten

Abstract

Purpose

It is reported that following abdominal surgery, transversus abdominis plane (TAP) block can reduce postoperative pain. The primary outcome of this study was the evaluation of the efficacy of TAP block on pain intensity following cesarean delivery with Pfannenstiel incision.

Methods

Fifty pregnant women were randomized blindly to receive either a TAP block with 15 ml 0.25% bupivacaine in both sides (group T, n = 25) or no blockade (group C, n = 25) at the end of the surgery, which was performed with a Pfannenstiel incision under general anesthesia. The pain intensity in the patients was assessed by a blinded investigator at the time of discharge from recovery and at 6, 12, and 24 h postoperatively, with a visual analogue scale (VAS) for pain.

Results

The women in the TAP block group had significantly lower VAS pain scores at rest and during coughing and consumed significantly less tramadol than the women in group C [50 mg (0–150) vs. 250 mg (0–400), P = 0.001]. There was a significantly longer time to the first request for analgesic in the TAP block group [210 min (0–300) vs. 30 min (10–180) in group C, P = 0.0001].

Conclusion

Two-sided TAP block with 0.25% bupivacaine in parturients who undergo cesarean section with a Pfannenstiel incision under general anesthesia can decrease postoperative pain and analgesic consumption. The time to the first analgesic rescue was longer in the parturients who received the TAP block.
Literatur
1.
Zurück zum Zitat Krivak TC, Zorn KK. Venous thromboembolism in obstetrics and gynecology. Obstet Gynecol. 2007;109(3):761–77.PubMedCrossRef Krivak TC, Zorn KK. Venous thromboembolism in obstetrics and gynecology. Obstet Gynecol. 2007;109(3):761–77.PubMedCrossRef
2.
Zurück zum Zitat Bijur PE, Schechter C, Esses D, Chang AK, Gallagher EJ. Intravenous bolus of ultra-low-dose naloxone added to morphine does not enhance analgesia in emergency department patients. J Pain. 2006;7(2):75–81.PubMedCrossRef Bijur PE, Schechter C, Esses D, Chang AK, Gallagher EJ. Intravenous bolus of ultra-low-dose naloxone added to morphine does not enhance analgesia in emergency department patients. J Pain. 2006;7(2):75–81.PubMedCrossRef
3.
Zurück zum Zitat Movafegh A, Razazian M, Hajimaohamadi F, Meysamie A. Dexamethasone added to lidocaine prolongs axillary brachial plexus blockade. Anesth Analg. 2006;102(1):263–7.PubMedCrossRef Movafegh A, Razazian M, Hajimaohamadi F, Meysamie A. Dexamethasone added to lidocaine prolongs axillary brachial plexus blockade. Anesth Analg. 2006;102(1):263–7.PubMedCrossRef
4.
Zurück zum Zitat Yu SC, Ngan Kee WD, Kwan AS. Addition of meperidine to bupivacaine for spinal anaesthesia for Caesarean section. Br J Anaesth. 2002;88:379–83.PubMedCrossRef Yu SC, Ngan Kee WD, Kwan AS. Addition of meperidine to bupivacaine for spinal anaesthesia for Caesarean section. Br J Anaesth. 2002;88:379–83.PubMedCrossRef
5.
Zurück zum Zitat Booth JV, Lindsay, Olufolabi AJ, EL-Moalem HE, Penning DH, Reynolds JD. Subarachnoid meperidine (Pethidine) causes significant nausea and vomiting during labor. Anesthesiology. 2000;93:418–21.PubMedCrossRef Booth JV, Lindsay, Olufolabi AJ, EL-Moalem HE, Penning DH, Reynolds JD. Subarachnoid meperidine (Pethidine) causes significant nausea and vomiting during labor. Anesthesiology. 2000;93:418–21.PubMedCrossRef
6.
Zurück zum Zitat Mc Donnell JG, O’Donnell BD, Curley G, Heffernan A, Pourer C, Laffey JG. The analgesic efficacy of transversus abdominis plane block after abdominal surgery: a prospective randomized controlled trial. Anesth Analg. 2007;104:193–7.CrossRef Mc Donnell JG, O’Donnell BD, Curley G, Heffernan A, Pourer C, Laffey JG. The analgesic efficacy of transversus abdominis plane block after abdominal surgery: a prospective randomized controlled trial. Anesth Analg. 2007;104:193–7.CrossRef
7.
Zurück zum Zitat Rafi AN. Abdominal field block: a new approach via the lumbar triangle. Anesthesia. 2001;56:1024–6.CrossRef Rafi AN. Abdominal field block: a new approach via the lumbar triangle. Anesthesia. 2001;56:1024–6.CrossRef
8.
Zurück zum Zitat O’Donnelle BD. The transversus abdominis plane block in open retropubic prostatectomy. Letter to the editor. Reg Anesth Pain Med. 2006;31(1):91. O’Donnelle BD. The transversus abdominis plane block in open retropubic prostatectomy. Letter to the editor. Reg Anesth Pain Med. 2006;31(1):91.
9.
Zurück zum Zitat Wittels B, Scott DT, Sinatra RS. Exogenous opioids in human breast milk and acute neonatal neurobehavior: a preliminary study. Anesthesiology. 1990;73:864–9.PubMedCrossRef Wittels B, Scott DT, Sinatra RS. Exogenous opioids in human breast milk and acute neonatal neurobehavior: a preliminary study. Anesthesiology. 1990;73:864–9.PubMedCrossRef
10.
Zurück zum Zitat Carney JJ, MC Donnell JG, Ochana A, Bhinder R, Laffey JG. The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy. Anesth Analg. 2008;107:2056–60.PubMedCrossRef Carney JJ, MC Donnell JG, Ochana A, Bhinder R, Laffey JG. The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy. Anesth Analg. 2008;107:2056–60.PubMedCrossRef
11.
Zurück zum Zitat MC Donnell JG, Curley G, Carney J, Benton A, Costello J, Maharaj CH. The analgesic efficacy of transversus abdominis plane block after cesarean delivery: a randomized controlled trial. Anesth Analg. 2008;106:186–91.CrossRef MC Donnell JG, Curley G, Carney J, Benton A, Costello J, Maharaj CH. The analgesic efficacy of transversus abdominis plane block after cesarean delivery: a randomized controlled trial. Anesth Analg. 2008;106:186–91.CrossRef
12.
Zurück zum Zitat Mukhtar K, Singh S. Transversus abdominis plane block for laparoscopic surgery. Br J Anaesth. 2009;109:143–4.CrossRef Mukhtar K, Singh S. Transversus abdominis plane block for laparoscopic surgery. Br J Anaesth. 2009;109:143–4.CrossRef
13.
Zurück zum Zitat Hebbard P. Audit of “rescue” analgesic using TAP block. Anaesth Intensive Care. 2007;35:617–8.PubMed Hebbard P. Audit of “rescue” analgesic using TAP block. Anaesth Intensive Care. 2007;35:617–8.PubMed
14.
Zurück zum Zitat Park T, Mickelson J, Yerkes E, Suresh S. Transversus abdominis plane block: a new approach to the management of secondary hyperalgesia following major abdominal surgery. Paediatr Anaesth. 2009;19:54–6. Park T, Mickelson J, Yerkes E, Suresh S. Transversus abdominis plane block: a new approach to the management of secondary hyperalgesia following major abdominal surgery. Paediatr Anaesth. 2009;19:54–6.
15.
Zurück zum Zitat Barrington MJ, Ivanusic JJ, Rosen WM, Hebbard P. Spread of injectate after ultrasound-guided sub costal transversus abdominis plane block: a cadaveric study. Anaesthesia. 2009;64:745–50.PubMedCrossRef Barrington MJ, Ivanusic JJ, Rosen WM, Hebbard P. Spread of injectate after ultrasound-guided sub costal transversus abdominis plane block: a cadaveric study. Anaesthesia. 2009;64:745–50.PubMedCrossRef
16.
Zurück zum Zitat Puddy E, Edwards B, Wrenchand I, Roberts F. Does the transversus abdominis plane (TAP) block improve analgesia following subarachnoid anesthesia with intrathecal diamorphine? A randomized double blinded control trial. Anaesthesia. 2010;65:95.CrossRef Puddy E, Edwards B, Wrenchand I, Roberts F. Does the transversus abdominis plane (TAP) block improve analgesia following subarachnoid anesthesia with intrathecal diamorphine? A randomized double blinded control trial. Anaesthesia. 2010;65:95.CrossRef
17.
Zurück zum Zitat Costello JF, Moore AR, Wieczorek PM, Macarthur AJ, Balki M, Carvalho JC. The transversus abdominis plane block, when used as part of a multimodal regimen inclusive of intrathecal morphine, does not improve analgesia after cesarean delivery. Reg Anesth Pain Med. 2009;34(6):586–9.PubMedCrossRef Costello JF, Moore AR, Wieczorek PM, Macarthur AJ, Balki M, Carvalho JC. The transversus abdominis plane block, when used as part of a multimodal regimen inclusive of intrathecal morphine, does not improve analgesia after cesarean delivery. Reg Anesth Pain Med. 2009;34(6):586–9.PubMedCrossRef
18.
Zurück zum Zitat Belavy D, Cowlishaw PJ, Howes M, Phillips F. Ultrasound-guided transversus abdominis plane block for analgesia after Caesarean delivery. Br J Anaesth. 2009;103(5):726–30.PubMedCrossRef Belavy D, Cowlishaw PJ, Howes M, Phillips F. Ultrasound-guided transversus abdominis plane block for analgesia after Caesarean delivery. Br J Anaesth. 2009;103(5):726–30.PubMedCrossRef
19.
Zurück zum Zitat Griffiths JD, Barron FA, Grant S, Bjorksten AR, Hebbard P, Royse CF. Plasma ropivacaine concentrations after ultrasound-guided transversus abdominis plane block. Br J Anaesth. 2010;105(6):853–6.PubMedCrossRef Griffiths JD, Barron FA, Grant S, Bjorksten AR, Hebbard P, Royse CF. Plasma ropivacaine concentrations after ultrasound-guided transversus abdominis plane block. Br J Anaesth. 2010;105(6):853–6.PubMedCrossRef
20.
Zurück zum Zitat Farooq M, Carey MA. A case of liver trauma with a blunt regional anesthesia needle while performing transversus abdominis plane block. Reg Anesth Pain Med. 2008;33(.3):274–5.PubMed Farooq M, Carey MA. A case of liver trauma with a blunt regional anesthesia needle while performing transversus abdominis plane block. Reg Anesth Pain Med. 2008;33(.3):274–5.PubMed
21.
Zurück zum Zitat Scharine JD. Bilateral transversus abdominis plane nerve blocks for analgesia following cesarean delivery: report of 2 cases. AANA J. 2009;77(2):98–102.PubMed Scharine JD. Bilateral transversus abdominis plane nerve blocks for analgesia following cesarean delivery: report of 2 cases. AANA J. 2009;77(2):98–102.PubMed
Metadaten
Titel
Transversus abdominis plane block reduces postoperative pain intensity and analgesic consumption in elective cesarean delivery under general anesthesia
verfasst von
Laleh Eslamian
Zorvan Jalili
Ashraf Jamal
Vajiheh Marsoosi
Ali Movafegh
Publikationsdatum
01.06.2012
Verlag
Springer Japan
Erschienen in
Journal of Anesthesia / Ausgabe 3/2012
Print ISSN: 0913-8668
Elektronische ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-012-1336-3

Weitere Artikel der Ausgabe 3/2012

Journal of Anesthesia 3/2012 Zur Ausgabe

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.