Contribución del bloqueo del plano transverso abdominal guiado por ultrasonidos a la analgesia postoperatoria tras la cesárea

Cánovas, L.; López, Cristina Pérez; Castro, Marcos Dopico; Rodríguez, A.B.; Pérez, Luisa González

doi:10.1016/j.redar.2012.09.024

Cited by 20 publications

(5 citation statements)

References 16 publications

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“…Several studies investigating the efficacy of the transverse plane block in managing postoperative pain in women undergoing caesarean sections have noted pain reduction up to 24 hours after surgery. 19,30,[36][37][38][39] Similar to our findings, certain researchers observed changes in the initial hours. For example, Lee's study reported pain reduction as early as 2 hours postoperation.…”

supporting

confidence: 91%

Transversus Abdominis Plane Block versus Epidural Anesthesia for Pain Management Post-Caesarean Delivery: A Pilot Study

Salazar-Flórez,

Arenas-Cardona,

Marhx

et al. 2024

LRA

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Background Effective post-operative analgesia profoundly influences patient recovery and outcomes after caesarean delivery. The Transversus Abdominis Plane (TAP) block represents a potential alternative, potentially offering greater effectiveness than epidural analgesia while causing fewer adverse effects. Objective To assess if the abdominal transverse block provides superior postoperative pain relief in patients undergoing caesarean delivery compared to epidural analgesia. Methods Participants were divided into parallel groups: an experimental group receiving TAP block (n=25) and a control group receiving epidural analgesia (n=24). All patients received a 10 mg dose of hyoscine at the end of the surgery. Experimental Group received a total of 20 mL of 0.2% ropivacaine. In Epidural group received 0.2% ropivacaine at 4 mL/h for 24 hours. All participants were administered combined with neuroaxial block anesthesia. The patients selected for epidural analgesia received the mentioned dose, while the other group block had the epidural catheter removed after the cesarean section. The primary outcome was post-caesarean pain, evaluated using the Visual Analog Scale (VAS) at four intervals (0, 6, 12, and 24 hours). Also, surgical bleeding and residual motor were evaluated. VAS pain scores between the groups were compared using the Friedman test and Generalized Linear Model (GLM) for non-normally distributed data. The effect size was estimated with Eta Square ( ), considering values ≥0.38 as indicative of large effects. A two-tailed p-value < 0.05 was deemed statistically significant. Results Statistically significant differences in pain scores were noted at 0 and 6 hours post-surgery (p<0.01). The TAP block group reported lower pain scores at 0 hours (mean=0.04) and 6 hours (mean=1.16) compared to the epidural group, reflecting a substantial effect size. Conclusion The TAP block proves advantageous in mitigating postoperative pain for women post-caesarean delivery, particularly in the initial 6 postpartum hours. This relief promotes early mother-infant bonding and facilitates breastfeeding.

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confidence: 91%

Transversus Abdominis Plane Block versus Epidural Anesthesia for Pain Management Post-Caesarean Delivery: A Pilot Study

Salazar-Flórez,

Arenas-Cardona,

Marhx

et al. 2024

LRA

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“…Out of the initial 59 unique article citations identified by the search strategy, 31 randomised controlled trials comprising a total of 2188 patients fulfilled the inclusion criteria (Fig. 1) [16, 28, 37–46, 29, 47–56, 30, 57, 31–36]. Twenty‐two, seven and two trials, with or without intrathecal morphine, compared TAP block with control, QLB with control and TAP with QLB, respectively.…”

Section: Resultsmentioning

confidence: 99%

Quadratus lumborum block vs. transversus abdominis plane block for caesarean delivery: a systematic review and network meta‐analysis^*

et al. 2020

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Summary Caesarean delivery is the most commonly performed inpatient surgical procedure globally. Pain after caesarean delivery is moderate to severe if not adequately treated, and is a primary anaesthetic concern for patients. Transversus abdominis plane and quadratus lumborum blocks are fascial plane blocks that have the potential to improve analgesia following caesarean delivery. Although proponents of the quadratus lumborum block suggest that this technique may provide better analgesia compared with transversus abdominis plane block, there are limited data directly comparing these two techniques. We, therefore, performed a systematic review and network meta‐analysis to compare transversus abdominis plane and quadratus lumborum block approaches, seeking randomised controlled trials comparing both techniques to each other, or to control, with or without intrathecal morphine. In all, 31 trials with 2188 patients were included and our primary outcome, the cumulative intravenous morphine equivalent consumption at 24 h, was reported in 12 trials. In the absence of intrathecal morphine, transversus abdominis plane and quadratus lumborum blocks were equivalent, and both were superior to control (moderate‐quality evidence). In the presence of intrathecal morphine, no differences were found between control, transversus abdominis plane and quadratus lumborum blocks (moderate‐quality evidence). Similar results were found for resting and active pain scores at 4–6 h, 8–12 h, 24 h and 36 h, although quadratus lumborum block was associated with lower pain scores at 36 h when compared with transversus abdominis plane block (very low‐quality evidence). However, transversus abdominis plane block was associated with a reduced incidence of postoperative nausea and vomiting (moderate‐quality evidence) and sedation when compared with inactive control following intrathecal morphine administration (low‐quality evidence). There are insufficient data to draw definitive conclusions, but transversus abdominis plane and quadratus lumborum block appear to be superior to control in the absence of intrathecal morphine, but provide limited additional benefit over inactive control when intrathecal morphine is also used.

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“…We included 114 trials (8730 women) in our final network analysis, 73 (64%) of which reported the primary outcome of morphine equivalent dose in the first 24 postoperative hours for 5126 (59%) women (Fig. 1 and online Supporting Information, Table S1) [14–127]. Placebo vs. transversus abdominis plane injection in 11 trials was the most common direct comparison.…”

Section: Resultsmentioning

confidence: 99%

Efficacy of regional blocks or local anaesthetic infiltration for analgesia after caesarean delivery: a network meta‐analysis of randomised controlled trials

et al. 2021

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Caesarean delivery is common and can cause severe postoperative pain but injection of local anaesthetic at various sites for regional blocks or local anaesthetic infiltration may reduce this. We aimed to compare and rank these sites. We searched PubMed, Google Scholar, EMBASE and CENTRAL to June 2021 for randomised controlled trials and performed a random-effects Bayesian model network meta-analysis. The primary outcome was dose of parenteral morphine equivalents in the first 24 postoperative hours. We used surface under cumulative ranking probabilities to order techniques. We analysed 114 trials (8730 participants). The ordered mean (95% credible interval) reduction in morphine equivalents, from 34 mg with placebo, were as follows: ilioinguinal 15 (1-32) mg; ilio-inguinal-iliohypogastric 13 (6-19) mg; transversalis fascia 11 (4-26) mg; erector spinae 11 (10-32); transverse abdominis 9 (4-13) mg; wound catheter infusion 8 (2-15) mg; quadratus lumborum 8 (1-15) mg; wound infiltration 8 (2-13) mg; and no intervention À4 (À10 to 2) mg. Ordered efficacies for injection sites were different for other relevant outcomes, including pain (to 4-6 h and to 24 h) and time to rescue analgesia: there was no single preferred route of injection. The ordered mean (95% credible interval) reduction in dynamic pain scores (0-10 scale) at 24 h compared with placebo were as follows: wound infusion 1.2 (0.2-2.1); erector spinae 1.3 (À0.5 to 3.1); quadratus lumborum 1.0 (0.1-1.8); ilio-inguinaliliohypogastric 0.6 (À0.5 to 1.8); transverse abdominis 0.6 (À0.1 to 1.2); wound infiltration 0.5 (À0.3 to 1.3); transversalis fascia À0.8 (À3.4 to 1.9); ilio-inguinal À0.9 (À3.6 to 1.7); and no intervention À0.8 (À1.8 to 0.2). We categorised our confidence in effect sizes as low or very low.

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Contribución del bloqueo del plano transverso abdominal guiado por ultrasonidos a la analgesia postoperatoria tras la cesárea

Cited by 20 publications

References 16 publications

Transversus Abdominis Plane Block versus Epidural Anesthesia for Pain Management Post-Caesarean Delivery: A Pilot Study

Transversus Abdominis Plane Block versus Epidural Anesthesia for Pain Management Post-Caesarean Delivery: A Pilot Study

Quadratus lumborum block vs. transversus abdominis plane block for caesarean delivery: a systematic review and network meta‐analysis^*

Efficacy of regional blocks or local anaesthetic infiltration for analgesia after caesarean delivery: a network meta‐analysis of randomised controlled trials

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Contribución del bloqueo del plano transverso abdominal guiado por ultrasonidos a la analgesia postoperatoria tras la cesárea

Cited by 20 publications

References 16 publications

Transversus Abdominis Plane Block versus Epidural Anesthesia for Pain Management Post-Caesarean Delivery: A Pilot Study

Transversus Abdominis Plane Block versus Epidural Anesthesia for Pain Management Post-Caesarean Delivery: A Pilot Study

Quadratus lumborum block vs. transversus abdominis plane block for caesarean delivery: a systematic review and network meta‐analysis*

Efficacy of regional blocks or local anaesthetic infiltration for analgesia after caesarean delivery: a network meta‐analysis of randomised controlled trials

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Quadratus lumborum block vs. transversus abdominis plane block for caesarean delivery: a systematic review and network meta‐analysis^*