&lt;p&gt;Comparison of Analgesic Effect Between Erector Spinae Plane Block and Transversus Abdominis Plane Block After Elective Cesarean Section: A Prospective Randomized Single-Blind Controlled Study&lt;/p&gt;

Boules, Maged Labib; Goda, Abeer Shaban; Abdelhady, Mahdy Ahmed; El-Azeem, Shimaa Adel Abu El-Nour Abd; Hamed, Mohamed Ahmed

doi:10.2147/jpr.s253343

Cited by 35 publications

(51 citation statements)

References 29 publications

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“…All ESPBs and TAPBs were performed in the anesthesia preparation room before the surgery by the same anesthesiologist, who was not involved in the rest of the study. The concentration and dose of local anesthetics refer to a previous study [ 21 ]. Midazolam 1 mg was given to all patients through intravenous access.…”

Section: Methodsmentioning

confidence: 99%

Comparison of Ultrasound-Guided Erector Spinae Plane Block and Oblique Subcostal Transverse Abdominis Plane Block for Postoperative Analgesia in Elderly Patients After Laparoscopic Colorectal Surgery: A Prospective Randomized Study

et al. 2021

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Introduction: Postoperative analgesia in elderly patients is still a thorny problem. Ultrasoundguided oblique subcostal transverse abdominis plane block (TAPB) has been demonstrated to provide postoperative analgesia after abdominal surgeries. However, recent studies have suggested that an alternative method, erector spinae plane block (ESPB), might also be effective. In this study, we compared the postoperative analgesic effects of ESPB and TAPB in elderly patients who had undergone laparoscopic colorectal surgery. Methods: Sixty-two elderly patients (C 65 years old) scheduled for elective laparoscopic colorectal surgery with general anesthesia were randomly allocated to two equally sized groups: ESPB group and TAPB group. The ESPB group had a bilateral erector spinae plane block, and the TAPB group had a bilateral oblique subcostal transverse abdominis plane block. The primary outcome was visual analogue scale (VAS) pain score during the first 24 postoperative hours at resting and active states. The secondary outcomes were postoperative consumption of sufentanil, satisfaction score, the number of patients who required antiemetics, incidence of block-related complications, and other side events. Results: There were no demographic differences between two groups. Compared to the TAPB group, the ESPB group had lower VAS pain scores and sufentanil consumption during the first 24 postoperative hours. Additionally, ESPB reduced the occurrence of postoperative nausea and vomiting. Furthermore, the satisfaction score was higher in the ESPB group. No other complications were reported between the two groups. Conclusions: Compared with oblique subcostal TAPB, ESPB more effectively reduced postoperative pain and opioid consumption. Thus, ESPB is suitable for postoperative analgesia in elderly patients who have undergone laparoscopic colorectal surgery.

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Section: Methodsmentioning

confidence: 99%

Comparison of Ultrasound-Guided Erector Spinae Plane Block and Oblique Subcostal Transverse Abdominis Plane Block for Postoperative Analgesia in Elderly Patients After Laparoscopic Colorectal Surgery: A Prospective Randomized Study

et al. 2021

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“…Two studies recently evaluated the erector spinae plane block (ESP) compared with TAP block and intrathecal morphine and in both studies the ESP block improved analgesia [122,123].…”

Section: Local and Regional Analgesia Techniquesmentioning

confidence: 99%

PROSPECT guideline for elective caesarean section: updated systematic review and procedure‐specific postoperative pain management recommendations

et al. 2020

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Caesarean section is associated with moderate-to-severe postoperative pain, which can influence postoperative recovery and patient satisfaction as well as breastfeeding success and mother-child bonding. The aim of this systematic review was to update the available literature and develop recommendations for optimal pain management after elective caesarean section under neuraxial anaesthesia. A systematic review utilising procedure-specific postoperative pain management (PROSPECT) methodology was undertaken. Randomised controlled trials published in the English language between 1 May 2014 and 22 October 2020 evaluating the effects of analgesic, anaesthetic and surgical interventions were retrieved from MEDLINE, Embase and Cochrane databases. Studies evaluating pain management for emergency or unplanned operative deliveries or caesarean section performed under general anaesthesia were excluded. A total of 145 studies met the inclusion criteria. For patients undergoing elective caesarean section performed under neuraxial anaesthesia, recommendations include intrathecal morphine 50-100 µg or diamorphine 300 µg administered pre-operatively; paracetamol; non-steroidal anti-inflammatory drugs; and intravenous dexamethasone administered after delivery. If intrathecal opioid was not administered, single-injection local anaesthetic wound infiltration; continuous wound local anaesthetic infusion; and/or fascial plane blocks such as transversus abdominis plane or quadratus lumborum blocks are recommended. The postoperative regimen should include regular paracetamol and non-steroidal anti-inflammatory drugs with opioids used for rescue. The surgical technique should include a Joel-Cohen incision; non-closure of the peritoneum; and abdominal binders. Transcutaneous electrical nerve stimulation could be used as analgesic adjunct. Some of the interventions, although effective, carry risks, and consequentially were omitted from the recommendations. Some interventions were not recommended due to insufficient, inconsistent or lack of evidence. Of note, these recommendations may not be applicable to unplanned deliveries or caesarean section performed under general anaesthesia.

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“…Due to the absence of a study directly comparing ESB and controls, the results of indirect comparisons showing that ESB reduced pain scores at 6 and 12 h need to be further confirmed. 74,76 Finally, we found that TFPB was not superior to controls for all outcomes we analyzed.…”

Section: Discussionmentioning

confidence: 81%

The Efficacy and Safety of Local Anesthetic Techniques for Postoperative Analgesia After Cesarean Section: A Bayesian Network Meta-Analysis of Randomized Controlled Trials

Wang¹,

Zhao²,

Song³

et al. 2021

JPR

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Objective Cesarean section (CS) is one of the most frequently performed major surgical interventions. Local anesthetic techniques, a universal component of perioperative multimodal analgesia, are reportedly effective in reducing pain scores and opioid requirements. However, the optimal local anesthetic technique for postoperative CS pain remains unclear. Methods Six databases were searched, and a Bayesian network meta-analysis was performed. The outcomes included cumulative morphine consumption and pain scores at four time points, time to first analgesic request, postoperative nausea and vomiting, pruritus, and sedation. Results Sixty-eight studies with 5039 pregnant women were included. Six local anesthetic techniques were involved, including transversus abdominis plane block (TAPB), ilioinguinal and iliohypogastric nerve block, quadratus lumborum blocks, transversalis fascia plane block, erector spinae block, and wound infiltration. Compared to inactive controls, TAPB reduced cumulative morphine consumption at 6, 12, 24, and 48 h, pain scores at 6, 12, and 24 h (with the exception of 24 h at rest), the risk of postoperative nausea and vomiting, and sedation. Compared with inactive controls, ilioinguinal and iliohypogastric nerve block reduced cumulative morphine consumption at 6 and 24 h and pain scores at 6, 12, and 24 h during movement. Compared with inactive controls, quadratus lumborum blocks reduced cumulative morphine consumption at 24 and 48 h and pain scores at 6 and 12 h and lengthened the time to first analgesic request. Compared with inactive controls, wound infiltration reduced cumulative morphine consumption at 12 and 24 h, pain scores at 12 and 24 h during movement, and risk of sedation. Compared with inactive controls, erector spinae block reduced pain scores at 6 and 12 h. Transversalis fascia plane block was found to have similar outcomes to inactive controls. Conclusion TAPB is the most comprehensive local anesthetic technique for postoperative CS analgesia in the absence of intrathecal morphine.

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<p>Comparison of Analgesic Effect Between Erector Spinae Plane Block and Transversus Abdominis Plane Block After Elective Cesarean Section: A Prospective Randomized Single-Blind Controlled Study</p>

Cited by 35 publications

References 29 publications

Comparison of Ultrasound-Guided Erector Spinae Plane Block and Oblique Subcostal Transverse Abdominis Plane Block for Postoperative Analgesia in Elderly Patients After Laparoscopic Colorectal Surgery: A Prospective Randomized Study

Comparison of Ultrasound-Guided Erector Spinae Plane Block and Oblique Subcostal Transverse Abdominis Plane Block for Postoperative Analgesia in Elderly Patients After Laparoscopic Colorectal Surgery: A Prospective Randomized Study

PROSPECT guideline for elective caesarean section: updated systematic review and procedure‐specific postoperative pain management recommendations

The Efficacy and Safety of Local Anesthetic Techniques for Postoperative Analgesia After Cesarean Section: A Bayesian Network Meta-Analysis of Randomized Controlled Trials

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