Bilateral Ultrasound-Guided Transversus Abdominis Plane Block Combined with Ilioinguinal-Iliohypogastric Nerve Block for Cesarean Delivery Anesthesia

Mei, Wei; Chuan-gang, Jin; Feng, Lin; Zhang, Yi; Luo, Ai-lun; Zhang, Chuanhan; Tian, Yuan

doi:10.1213/ane.0b013e31821891e2

Cited by 20 publications

(7 citation statements)

References 15 publications

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“…Studies on TAP block using various techniques were done in various subsets of surgeries like prostatectomy, large bowel resection, open or lap appendicectomy, C-sections, total abdominal hysterectomies, cholecystectomies, hepatic and renal surgeries, and abdominoplasties. [ 1 3 10 11 12 13 14 15 16 17 18 ] Our study was in a subset of patients posted for emergency laparotomy, secondary to hollow viscous perforations and intestinal obstructions, where the surgical incision usually extended above the umbilicus and administration of an epidural was relatively contraindicated in view of the difficulty in positioning due to pain and abdominal distention. Coagulopathies and hemodynamic instability associated with neuraxial sympathetectomy were also relative contraindications for epidurals.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of transversus abdominis plane block in patients undergoing emergency laparotomies

et al. 2014

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Background:Pain experienced following laparotomy is largely due to abdominal wall incision. Effective mitigation of this pain is vital to improve patient satisfaction and for early ambulation. We evaluated the efficacy of transversus abdominis plane (TAP) block for postoperative analgesia, as a component of multimodal analgesia.Materials and Methods:Sixty adult ASA physical status I to III patients undergoing emergency laparotomy under general anesthesia were recruited for this double-blind, randomized, controlled trial. The TAP block was performed before skin incision, using the double pop technique in the midaxillary line, at the level of the umbilicus with a 22 gauge blunt needle. The patients were randomly assigned to receive either 25 ml of 0.25% bupivacaine or normal saline (NS), bilaterally. Tramadol was used for postoperative analgesia via a patient-controlled analgesia pump (PCA) along with an intramuscular (IM) injection of diclofenac sodium, 12-hourly. Each patient was assessed in the Post Anesthesia Care Unit (PACU) immediately after shifting and every two hours thereafter, for 24 hours, for pain, nausea, sedation scores, and pruritus. The two-hourly and total tramadol consumption, over 24 hours, was assessed.Results:The mean total pain scores were significantly less in the TAP block group (48.07 ± 6.76) when compared to the control group (62.63 ± 6.66). The total tramadol consumption was decreased by 36% in the TAP block group (281.33 ± 69.66 mg) compared to the control group (439 ± 68.59 mg). Tramadol consumption measured every two hours was also less up to 18 hours postoperatively, after which, there was an increase in pain scores and tramadol consumption in the TAP block group. There was no statistically significant difference between the two groups in terms of nausea, vomiting, sedation or pruritis.Conclusion:TAP block is an effective component of the multimodal analgesia regimen for reducing postoperative pain and opioid requirement after emergency laparotomy.

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Section: Discussionmentioning

confidence: 99%

Efficacy of transversus abdominis plane block in patients undergoing emergency laparotomies

et al. 2014

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“…The practice of regional nerve block techniques by health professionals for postoperative pain management is rising, and demonstrated a decrease requirement of supplementary analgesia [12,13] Moreover, abdominal field nerve blocks as part of multimodal analgesia with parenteral analgesics are becoming popular for postoperative pain management after caesarean delivery [5,14,15]. Furthermore, ilioinguinal and iliohypogastric (II-IH) nerve blocks are widely practiced for the treatment of postoperative pain after caesarean delivery [2] and for analgesia for different age groups of patients undergoing hernia repair [16,17].…”

Section: Introductionmentioning

confidence: 99%

Analgesic Efficacy of Bilateral Ilioinguinal and Iliohypogastric Nerve Block for Post Caesarean Delivery Under Spinal Anaesthesia, 2016. Double blind randomized Study

Nigatu¹,

Gebremedhn²,

Tawuye³

et al. 2017

J Anesth Clin Res

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Background: Pain after cesarean section is a common phenomenon. Optimal postoperative pain control is paramount as it facilitates early mobilization of the mother, decrease patient morbidity, improve mother -new born bonding and patient satisfaction. This study was designed to determine the analgesic efficacy of bilateral ilioinguinal and iliohypogastric nerve block for caesareans delivery under spinal anaesthesia in the first 24 post-operative hours, Gondar University hospital, Northwest Ethiopia.

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“…This technique was first described in 2009 in a small case series 50 . Two years later, the same group showed similar pain control between epidural and TAP catheter analgesia in randomized study 27 . In both reports, an intermittent bolus protocol was used.…”

Section: Resultsmentioning

confidence: 72%

Postoperative Analgesia of Transversus Abdominis Plane Block After Cesarean Delivery Under General Anesthesia

Flaifel¹,

Muhalhil²,

Alwaeely³

et al. 2013

Basrah Journal of Surgery

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Cesarean delivery under general anesthesia requires effective postoperative analgesia for early ambulation and breast feeding. Transversus abdominis plane (TAP) block is done by injecting local anesthetic solution in the plane between internal oblique and transversus abdominis muscles on either sides of the abdominal wall to prolong postoperative analgesia. One hundred pregnant women who underwent general anesthesia for cesarean delivery were randomized in to two equal groups;TAP block group versus control group. This block was performed bilaterally using 20 mls of 0.25% plain bupivacaine on each side. Each patient was assessed postoperatively by a blinded investigator at 2, 4, 6,12, 24 hours using numerical pain score (NPS) 0-10 at rest and movement. Narcotics consumption, drug side effects, and patient`s satisfaction were recorded. There were no significant differences between patients characteristics. Postoperative pain at rest as measured by NPS showed; medians (3-6) and means (3-5.5) in the control group; which were significantly (p<0.05) higher than those in TAP block group which did not exceed. During movement, NPS medians (4.5-8) and means (4.5-8.5) in the control group were significantly (p<.05) higher than those in TAP block group where never exceeded. Narcotic consumptions decreased to 50% in TAP block group. Pethidine requested by 30% of patients in the control group versus 14% of TAP group. Unilateral block observed in 1/50 (0.02%), no other complications reported from TAP block. Patients satisfactions for analgesia rated good by 82% in TAP block group versus 40% in control group. In conclusion, transversus abdominis plane block provides good & prolonged postoperative analgesia after cesarean delivery performed under general anesthesia when it is combined to multimodal analgesia.

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Bilateral Ultrasound-Guided Transversus Abdominis Plane Block Combined with Ilioinguinal-Iliohypogastric Nerve Block for Cesarean Delivery Anesthesia

Cited by 20 publications

References 15 publications

Efficacy of transversus abdominis plane block in patients undergoing emergency laparotomies

Efficacy of transversus abdominis plane block in patients undergoing emergency laparotomies

Analgesic Efficacy of Bilateral Ilioinguinal and Iliohypogastric Nerve Block for Post Caesarean Delivery Under Spinal Anaesthesia, 2016. Double blind randomized Study

Postoperative Analgesia of Transversus Abdominis Plane Block After Cesarean Delivery Under General Anesthesia

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