Transversus abdominis plane block vs. wound infiltration in <scp>C</scp>aesarean section: a randomised controlled trial

Telnes, A.; Skogvoll, Eirik; Lonnée, H.

doi:10.1111/aas.12498

Cited by 54 publications

(45 citation statements)

References 31 publications

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“…Bilateral US-guided lateral TAP blocks have also been compared with wound site infiltration in 3 studies of cesarean delivery under spinal anesthesia without intrathecal morphine. [241][242][243] Two of the studies 241,242 reported no difference in analgesic outcomes between groups, whereas the third 243 found that TAP blocks reduced pain scores and increased time to first analgesic request.…”

Section: Tap Block Versus Other Analgesic Strategies In Cesarean Delimentioning

confidence: 99%

Essentials of Our Current Understanding

Chin

McDonnell

Carvalho

et al. 2017

Regional Anesthesia and Pain Medicine

347

208

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Abdominal wall blocks rely on the spread of local anesthetic within musculofascial planes to anesthetize multiple small nerves or plexuses, rather than targeting specific nerve structures. Ultrasonography is primarily responsible for the widespread adoption of techniques including transversus abdominis plane and rectus sheath blocks, as well as the introduction of novel techniques such as quadratus lumborum and transversalis fascia blocks. These blocks are technically straightforward and relatively safe and reduce pain and opioid requirements in many clinical settings. The data supporting these outcomes, however, can be inconsistent because of heterogeneity of study design. The extent of sensory blockade is also somewhat variable, because it depends on the achieved spread of local anesthetic and the anatomical course of the nerves being targeted. The blocks mainly provide somatic analgesia and are best used as part of a multimodal analgesic regimen. This review summarizes the anatomical, sonographic, and technical aspects of the abdominal wall blocks in current use, examining the current evidence for the efficacy and safety of each.

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Section: Tap Block Versus Other Analgesic Strategies In Cesarean Delimentioning

confidence: 99%

Essentials of Our Current Understanding

Chin

McDonnell

Carvalho

et al. 2017

Regional Anesthesia and Pain Medicine

347

208

View full text Add to dashboard Cite

show abstract

“…In a prior report on patients undergoing cesarean section, TAP block failed to convey an advantage over wound infiltration [20]. It may be that apparent differences in the patient population as well as incisions location may have accounted for the diverging results.…”

Section: Discussionmentioning

confidence: 89%

Pain Control after Laparoscopic Radical Prostatectomy: Comparison between Unilateral Transversus Abdominis Plane Block and Wound Infiltration

et al. 2019

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Background and Objectives: To determine the efficacy of unilateral transversus abdominis plane (TAP) block versus wound local infiltration for postoperative pain following laparoscopic radical prostatectomy (LRP). Methods: Data of consecutive patients who underwent extraperitoneal LRP and received either wound infiltration or unilateral TAP block for analgesia were retrospectively analyzed. The patients were divided into 2 groups based on the technique used. We compared pain intensity scores and on-demand analgesic use both during the hospital stay and post-discharge between the 2 groups. Results: A total of 48 patients were included, 27 received unilateral TAP blocks (group 1) and 21 were managed with wound infiltration (group 2). The unilateral TAP block group showed lower median pain scores on postoperative days (POD) 1 with pain scores being 0.2 (0–4) and 0.8 (0–4), respectively (p < 0.05). On POD2, the median pain intensity was 0.9 (0–5) and 1.6 (0–6) in groups 1 and 2, respectively (p < 0.05). The median number of on-demand analgesic doses during the POD1 was 0.2 (0–2) and 0.4 (0–2) in groups 1 and 2, respectively (p = 0.19). On POD2, the patients received 0.5 (0–2) and 1.1 (0–3) on-demand doses in groups 1 and 2, respectively (p < 0.05). Conclusion: Unilateral TAP block might improve pain control more pronounced after LRP than wound infiltration.

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“…However, trial comparing local wound infiltration with TAP block after other abdominal surgery as cesarean section were few (12,13,14,15) . Also, meta-analysis of trial comparing TAP block with wound infiltration after abdominal surgery were few (18,19) .…”

Section: Discussion:-mentioning

confidence: 99%

“…Telnes et al (13) using 40 ml, 0.25% bupivacaine with 5mg/ml of Adrenaline for TAP block or LWI and they found no significant difference as regards cumulative morphine consumption as well as pain scores at 12, 24, 36, 48 hours. Also, there were no difference regards time to first analgesic need and incidence of nausea and vomiting.…”

Section: Aydogmus Et Almentioning

confidence: 98%

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Transversus Abdominis Plane (Tap) Block Versus Local Anesthetic Wound Infiltration (Lwi) for Post Total Abdominal Hysterectomy (Tah) Pain Relief.

Sherbeny¹,

Abdelzaam²

2017

IJAR

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Total abdominal hysterectomy, visual analogue scale, Bupivacaine, transversus abdominis plane block, local anesthetic wound infiltration, opioids consumption.Aim: to compare bilateral ultrasound guided transversus abdominis plane (TAP) block with single -shot -local anesthetic subcutaneous and sub facial wound infiltration (LWI) for analgesia after total abdominal hysterectomy (TAH) under general anesthesia. Patients and methods: This prospective randomized, parallel group, concealed allocation, patients and observers blinded superiority trial, conducted at Benha University Hospital, including 87 women undergoing TAH, 43 women received 40 ml 0.25 bupivacaine as bilateral ultrasound guided TAP block and 44 women received 40 ml, 0.25% bupivacaine as subcutaneous and sub facial local wound infiltration at the end of TAH performed under general anesthesia. Main outcomes were total cumulative Nalbuphine consumption and post TAH pain at rest and with movement using visual analogue scale (VAS) as well as incidence of nausea, vomiting, other analgesic requirements, time spent in post anesthesia care unit (PACU), time to get out of bed, deepest sedation, patient satisfaction regards analgesia in First 24 hour postoperative. Results: Total Nalbuphine consumption were significantly lower in TAP block group at 2, 4, 8, 12, 24 hours and at discharge (P < 0.0001). The mean post TAH pain VAS score both at rest and on movement were significantly lower in TAP block group at PACU, 2h, 8h, 12h (P < 0.05) as well as at 4h on movement (P < 0.05). Also, total non-steroidal anti-inflammatory drugs (NSAIDs) consumption were lower in TAP block up to twenty-four hours postoperatively (P < 0.005), time to get out of bed (P = 0.03) and time to first flatus (P = 0.0002). Conclusion: Bilateral ultrasound guided TAP block is superior to local anesthetic wound infiltration in analgesia for post TAH pain as Tap block was associated with reduced both rest and on movement postoperative pain and total cumulative opioids analgesia as well as promotes early mobilization and gut recovery.

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Transversus abdominis plane block vs. wound infiltration in Caesarean section: a randomised controlled trial

Abstract: Compared with wound infiltration with local anaesthetics, TAP block did not reduce cumulative morphine consumption following CS. The TAP block was associated with more pronounced sedation.

Cited by 54 publications

References 31 publications

Essentials of Our Current Understanding

Essentials of Our Current Understanding

Pain Control after Laparoscopic Radical Prostatectomy: Comparison between Unilateral Transversus Abdominis Plane Block and Wound Infiltration

Transversus Abdominis Plane (Tap) Block Versus Local Anesthetic Wound Infiltration (Lwi) for Post Total Abdominal Hysterectomy (Tah) Pain Relief.

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