Ultrasound-guided transversus abdominis plane block for analgesia after Caesarean delivery

Belavy, David; Cowlishaw, Phillip; Howes, Marten; Phillips, Fiona

doi:10.1093/bja/aep235

Cited by 318 publications

(287 citation statements)

References 9 publications

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“…In our study of a Control group and the QLB I group, the median of the total morphine dose administered subcutaneously in the first 24 hours was 20mg and 10mg respectively; and during the first 48 hours 30 mg and 15 mg respectively. This result compares with other authors' studies which evaluated morphine consumption by PCA iv during the first 24 hours, where performing the QLB II or TAPB had results of 7.5 mg, 18 mg, 19 mg and 25 mg across the different studies [14,21,22,26].…”

Section: Discussionsupporting

confidence: 46%

“…Various analyses showed that the Transversus Abdominis Plane Block (TAPB) is an effective tool to fight postoperative pain in terms of reducing the total dose of opioids, but only when spinal morphine is not used [21,22]. Carney et al demonstrated, by using an MRI of the chest and abdomen, when comparing between four groups of volunteers, that the spread of LA after TAPB occurs only in the area of the transversus abdominis plane, determining a slowdown of only somatic pain and providing a sensory block only within the scope of the innervation of Th9-Th10 or Th11-L1.…”

Section: Discussionmentioning

confidence: 99%

“…Another important difference between our study and that of Blanco et al, which can affect the outcome of the efficiency of analgesic QLB, was the type, concentration and volume of the LA used. In our study, to avoid the possible toxic effects of bupivacaine, which was used in the study by Blanco et al and other authors, we performed the QLB by using the less-toxic ropivacaine (though of a weaker efficiency than bupivacaine), which had also often been used by other researchers working on the effectiveness of analgesic TAPB [22,32].…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the effectiveness of the Quadratus Lumborum Block type I using ropivacaine in postoperative analgesia after a cesarean section — a controlled clinical study

et al. 2018

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Objectives: Quadratus Lumborum Block in contrast to Transversus Abdominis Plane Block contains a unique component which not only stops somatic pain but also inhibits visceral pain by spreading the local anesthetic to the paravertebral space. This study was designed to determine whether performing the Quadratus Lumborum Block type I in patients undergoing cesarean section would be associated with both decreased morphine consumption and decreased pain levels in the postoperative 48-hour period. Material and methods:Sixty patients undergoing caesarean section under spinal anesthesia were randomly and equally assigned to one or other of two groups: QLB I (who received Bilateral Quadratus Lumborum Block type I with the use of 24 mL 0.375% ropivacaine per side) or a Control group. In both groups, on-demand morphine analgesia was administered postoperatively within the first 48 hours. The following were measured: the morphine consumption; the time elapsed from the C-section until the first dose of morphine; and the levels of pain intensity among patients in rest (numeral pain rating scale).Results: There were no statistically significant demographic data differences between the QLB I and Control groups. The following significant differences were observed in the 48-hour postoperative period: morphine consumption was higher in the Control group (p = 0.000); the time elapsed from the C-section until the first dose of morphine was longer in QLB I group (p < 0.05); and the median of the pain numeric rating scale was higher in the Control group (p < 0.05). Conclusions:Quadratus Lumborum Block type I significantly reduces morphine consumption and pain levels up to 48 hours postoperatively.

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Section: Discussionsupporting

confidence: 46%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Evaluation of the effectiveness of the Quadratus Lumborum Block type I using ropivacaine in postoperative analgesia after a cesarean section — a controlled clinical study

et al. 2018

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“…Diclofenac) was statistically significantly prolonged in study group (669.66±346 minutes) compared to the control group (220.33 ± 139.24 minutes). In studies performed by John Carney, Mc Donnell et al [6] in total abdominal hysterectomy and D. Belavy et al [9] in caesarean section, the time to first analgesic demand was 3-4 hours after completion of surgical procedure which was less compared to our study. This difference may be attributed to TAP block given before surgery where as we have given TAP block at the end of surgery.…”

Section: Discussioncontrasting

confidence: 70%

“…Recent studies by Hebbard et al [14,15] (posterior TAP block), T. M. Tran (cadaveric study), Dawlathy (Lap cholecystectomy) [7], Niraj et al (open appendicectomy) [8] , Belary et al (caesarean section delivery) [9] , D.J Sandeman (Lap appendicectomy) [11] have all proved that "In plane" USG guidance ensures the exact position of LA between the IOAM and TAM, resulting in improve safety and efficacy.…”

Section: Discussionmentioning

confidence: 99%

Observational Study to Evaluate Transversus Abdominis Plane (TAP) Block in Abdominal Surgery by Total Requirement of Diclofenac as a Post Operative Analgesia drug

Patel¹,

Shah²,

Bhiwal³

2015

Int Jour of Biomed Res

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Background: Transversus Abdominis Plane Block (TAPB) is a regional anesthesia technique. It provides analgesia after lower abdominal surgery particularly where parietal wall pain forms major component of pain. It allows sensory blockade of lower abdominal wall skin and muscles via local anesthetic deposition between Transversus Abdominis muscle and internal oblique muscle. We evaluated efficacy of unilateral TAPB with bupivacaine for postoperative analgesia in hernia repair in a hospital based, double blind, and prospective, randomized controlled clinical trial. Method: 60 patients undergoing elective unilateral inguinal hernioplasty surgery were randomized to undergo TAPB with bupivacaine (n =30) in study group and without TAPB in control group (n=30). At end of surgery performed under spinal anesthesia unilateral TAPB on side of surgery was performed using 20 ml of 0.25 % bupivacaine in study group. Each patient was assessed postoperatively by a blinded investigator in postanesthesia care unit at 30 min., 2, 4, 6, 12, 18, 24 hours. The time required for first dose of rescue analgesia, vas score, total consumption of diclofenac was assessed in each group and comparison were performed by student ttest. Result: Mean duration of analgesia was 669.66 minutes with SD of +346 in study group and 220.33 minutes with SD of +139.24 in control group which was found to be statistically significant. VAS score was significantly higher in control group as compared to the study group at all the time. Total dose of diclofenac consumption in study group was 95±33.73mg and in control group it was 202.5±44.69mg, which showed that diclofenac consumption was significantly decreased in study group. Conclusion: TAPB with 0.25% bupivacaine provided potent and longer duration of analgesia, with very less requirement of diclofenac when used in patients of inguinal hernioplasty. There were no complications attributable to TAPB or drugs under study.

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The Trunk

and¹,

Schroeder²

2013

Small Animal Regional Anesthesia and Analgesia

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Ultrasound-guided transversus abdominis plane block for analgesia after Caesarean delivery

Abstract: The US-guided TAP block reduces morphine requirements after Caesarean delivery when used as a component of a multimodal analgesic regimen. Registered with the Australia New Zealand Clinical Trials Registry ACTRN12608000540314. URL: http://www.anzctr.org.au/trial_view.aspx?ID=83176.

Cited by 318 publications

References 9 publications

Evaluation of the effectiveness of the Quadratus Lumborum Block type I using ropivacaine in postoperative analgesia after a cesarean section — a controlled clinical study

Evaluation of the effectiveness of the Quadratus Lumborum Block type I using ropivacaine in postoperative analgesia after a cesarean section — a controlled clinical study

Observational Study to Evaluate Transversus Abdominis Plane (TAP) Block in Abdominal Surgery by Total Requirement of Diclofenac as a Post Operative Analgesia drug

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