Subarachnoid morphine versus TAP blocks for enhanced recovery after caesarean section delivery: A randomized controlled trial

Jarraya, A.; Zghal, Jamil; Abidi, S.; Smaoui, M.; Kolsi, K.

doi:10.1016/j.accpm.2015.10.012

Cited by 23 publications

(40 citation statements)

References 14 publications

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“…In the presented study, subarachnoid analgesia was obtained using 0.5% hyperbaric bupivacaine and 0.25% hyperbaric bupivacaine was used for the TAP block. Opioids were not administered into the subarachnoid space due to lack of sufficient postoperative monitoring of the patients and in order to avoid possible complications, such as pruritus and difficulties in passing urine [9,10]. The ultrasound-guided TAP block is a simple and safe analgesic technique.…”

Section: Discussionmentioning

confidence: 99%

The analgesic efficiency of transversus abdominis plane (TAP) block after caesarean delivery

Kupiec¹,

Zwierzchowski²,

Kowal-Janicka³

et al. 2018

Ginekol Pol

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Section: Discussionmentioning

confidence: 99%

The analgesic efficiency of transversus abdominis plane (TAP) block after caesarean delivery

Kupiec¹,

Zwierzchowski²,

Kowal-Janicka³

et al. 2018

Ginekol Pol

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“…The ERP is a standardized interdisciplinary and evidence-based approach involving nursery teams, surgeons, anesthesiologists, and postpartum teams, to improve the care of patients who are undergoing surgeries [2,8]. The ERP is not only for humanistic purposes, but it is also used for economic purposes [1,3,[8][9]. When ERP is combined with an audit system and multidisciplinary team, it results in the reduction of surgical stress, enhances physiological and functional recovery, and decreases hospital stay, rapid return to regular activity, and fewer complications [3,[8][9].…”

Section: Introductionmentioning

confidence: 99%

“…The ERP is not only for humanistic purposes, but it is also used for economic purposes [1,3,[8][9]. When ERP is combined with an audit system and multidisciplinary team, it results in the reduction of surgical stress, enhances physiological and functional recovery, and decreases hospital stay, rapid return to regular activity, and fewer complications [3,[8][9]. Therefore, ERP has a triple aim; improving quality of care, increase patient satisfaction, and decreasing the costs [10].…”

Section: Introductionmentioning

confidence: 99%

“…Neonatal care is another elements of postoperative in ERP and should be commenced with delaying cord clamping; at least 30 seconds for preterm baby and one minute at term, maintaining the body temperature of the newborn between 36.5 °C and 37.5 °C, and resuscitation in room air immediately [8]. Analgesia is the main principle of ERP after C/S, and a multimodal approach to the management of pain is needed in order to limit the use of opioids [9,15]. Neuraxial analgesia, such as spinal or epidural analgesia, can reduce pain in patients who are undergoing C/S [15].…”

Section: Introductionmentioning

confidence: 99%

“…Neuraxial analgesia, such as spinal or epidural analgesia, can reduce pain in patients who are undergoing C/S [15]. Epidural or Subarachnoid morphine injection, despite its side effects such as nausea, vomiting, pruritus, urinary retention, sedation, and respiratory depression, is the gold standard for controlling postoperative pain after C/S [9,15]. Also, a transversus abdominis plane block is another route of analgesia which associated with less gastrointestinal transit [9].…”

Section: Introductionmentioning

confidence: 99%

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Enhanced Recovery Program after Cesarean Section in Sulaimani Maternity Teaching Hospital

Mohammed

Jawad

Murad

2020

KJAR

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Enhanced recovery program (ERP) for cesarean section (C/S) is improving patient health and is cost-effective for healthcare providers. We aimed to assess how ERP improves patient satisfaction, ambulation time, severity of pain, decrease hospital stay among patients attending Sulaimani Maternity Teaching Hospital and fetal outcome. A quasi-experimental study was performed on 200 patients in Sulaimani from June 2019 to December 2019. The participants divided into two equal groups. The intervention group was 100 women who underwent elective C/S in Sulaimani Maternity Teaching Hospital and subjected to ERP. While the control group was the other 100 women who were not subjected to the ERP, and they were from the Emergency Department of the same hospital. The women in the intervention group were supervised by anesthetists from preoperatively, intraoperatively, through postoperatively. The intervention group showed significantly better outcome regarding time to ambulate; all patients were able to ambulate 4-5 hours postoperatively. Also, the duration of hospital stay was better in the intervention group; all the patients discharged before 24 hours, but five patients in the control group discharged after 24 hours. Besides, fetal Apgar score after five minutes was also better in the intervention group; at the first minute, the mean±SD (standard deviation) of Apgar score was 8.36±1.38 and 8.08±1.69 for the intervention, and control groups, respectively (P-value = 0.2). While at five minutes, the mean±SD of Apgar score was 9.59±064, and 8.96±1.12 for the intervention, and control groups, respectively (P-value = <0.001). This intervention had favorable outcomes regarding pain, time of ambulation, and fetal Apgar score. We recommend implementing ERP at a broader scale as it gives better outcomes.

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Postoperative pain control and opioid use with transversus abdominis plane block and scheduled multimodal pain management in patients undergoing cesarean section

Richards,

Dunn,

Chellappa

et al. 2024

Intl J Gynecology & Obste

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ObjectiveThe impact of a transversus abdominis plane (TAP) block in patients undergoing cesarean section requires further evaluation. The aim of this study was to compare postoperative pain scores and opioid use in cesarean surgery patients undergoing either a TAP block and scheduled multimodal pain management (SMPM) or SMPM alone.MethodsIn this retrospective, dual cohort study, cesarean surgery patients underwent neuraxial anesthesia and a TAP block (SMPM/TAP) or SMPM; the TAP block incorporated ropivacaine (20–30 mL) administered bilaterally. The group analyses involved a comparison of postoperative pain scores using the visual analog scale and opioid consumption at 24 and 24–48 h.ResultsThere were 94 (52.8%) patients in the SMPM/TAP group and 84 (47.2%) subjects in the SMPM alone group. At 24 h postoperatively, the SMPM/TAP group exhibited significantly lower pain scores (4.07 vs 4.54) than the SMPM group (P < 0.001) and reduced opioid consumption (2.29 vs 3.28 mg; P < 0.001). However, at 24–48 h, the SMPM group demonstrated lower pain scores (5.46 vs 5.98) compared to the SMPM/TAP group (P < 0.001) and reduced opioid consumption (8.75 vs 10.21 mg; P < 0.001); overall opioid consumption was higher (12.50 vs 12.02 mg) in the SMPM/TAP group (P < 0.001).ConclusionThe TAP block improved cesarean surgery patients' pain scores and reduced opioid consumption at 24 h postoperatively but the effect of the TAP block was ephemeral as the SMPM/TAP group exhibited inferior pain scores and greater opioid consumption compared to the SMPM group at 24–48 h postoperatively.

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Subarachnoid morphine versus TAP blocks for enhanced recovery after caesarean section delivery: A randomized controlled trial

Cited by 23 publications

References 14 publications

The analgesic efficiency of transversus abdominis plane (TAP) block after caesarean delivery

The analgesic efficiency of transversus abdominis plane (TAP) block after caesarean delivery

Enhanced Recovery Program after Cesarean Section in Sulaimani Maternity Teaching Hospital

Postoperative pain control and opioid use with transversus abdominis plane block and scheduled multimodal pain management in patients undergoing cesarean section

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