Transversus abdominis plane block provides postoperative analgesic effects after cesarean section: Additional analgesia to epidural morphine alone

2013 ◽  
Vol 39 (9) ◽  
pp. 1397-1405 ◽  
Author(s):  
Yoko Onishi ◽  
Rie Kato ◽  
Toshiyuki Okutomi ◽  
Ken-ichi Tabata ◽  
Kan Amano ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Epidural Morphine ◽  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Transversus Abdominis Plane ◽  
Analgesic Effects

scholarly journals Intrathecal morphine versus transversus abdominis plane block for caesarean delivery: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tao-ran Yang ◽  
Xue-mei He ◽  
Xue-han Li ◽  
Ru-rong Wang
Keyword(s):  
Sensitivity Analysis ◽  
Side Effects ◽  
Pain Score ◽  
Caesarean Delivery ◽  
Intrathecal Morphine ◽  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Transversus Abdominis Plane ◽  
Analgesic Effects ◽  
Registration Number

Abstract Background The number of caesarean deliveries has been increasing. Although intrathecal morphine (ITM) can relieve pain and is widely applied in caesarean deliveries, it is associated with many side effects. Transversus abdominis plane block (TAPB), a new analgesic technology, has also began playing a certain role after caesarean delivery, with fewer adverse effects. This study mainly compares the analgesic and adverse effects of ITM and TAPB in caesarean delivery. Methods We systematically searched PubMed, Cochrane Library, EMBASE, and Web of Science, for randomised controlled trials (RCTs) published before 9 October, 2020 to compare the effects of ITM and TAPB. Primary outcome of the study was the pain score at rest 24 h after caesarean delivery, whereas the secondary outcomes were the pain score at movement 24 h after operation, postoperative nausea and vomiting (PONV), itching, and morphine consumption. For the outcome assessment, we conducted a sensitivity analysis. Result Six RCTs involving 563 patients and meeting the study inclusion criteria were included in this study. Results indicated no significant difference in the pain score between ITM and TAPB at 24 h of rest or movement. The sensitivity analysis results indicated that the resting pain score (95% CI = − 1.27 to − 0.28; P = 0.002) and 24-h moving pain score (95% CI = − 1.8 to − 0.07; P = 0.03) of the ITM group were lower than those of the TAPB group. The consumption of morphine in the ITM group was lower than in the TAPB group (95% CI = 1.92 to 4.87; P < 0.00001); however, in terms of adverse reactions, the incidence of pruritus (95% CI = 1.17 to 8.26; P = 0.02) and PONV (95% CI = 1.92 to 4.87, P < 0.00001) in the ITM group was higher than in the TAPB group. Conclusion Parturients in the ITM and TAPB groups exhibited similar analgesic effects. However, in the sensitivity analysis performed by eliminating the studies causing heterogeneity, the ITM group was found to have superior analgesic effects compared with the TAPB group, with less morphine consumption. Differently, the TAPB group displayed less side effects such as PONV. Therefore, TAPB is still a valuable analgesia option for patients who cannot use ITM for analgesia after caesarean delivery or those having a high risk of PONV. Trial registration Registration number: Registered on Prospero with the registration number of CRD42020210135.

Management of cesarean delivery in a parturient with osteogenesis imperfecta：A case report

2020 ◽  
pp. 1-3
Keyword(s):  
Cesarean Section ◽  
Vital Signs ◽  
Bone Fragility ◽  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Mother And Daughter ◽  
Blue Sclera ◽  
Written Informed Consent

Osteogenesis imperfecta (OI) is characterized by bone fragility, defects in the teeth, blue sclera, and deficits in hearing and vision [1,2]. Because of an anticipated difficult airway and back anatomy, there is a high risk of choosing either general or spinal anesthesia, especially in critically ill obstetric patients. It is still controversy about the anesthesia method in patients with OI. Ultrasound-guided transversus abdominis plane block (TAPB) has been used for analgesia after cesarean section, but rarely for anesthesia in this operation [3-5]. We describe a critically parturient with OI who underwent cesarean section under ultrasound guided TAPB with spontaneous breathing general anesthesia. The patient's vital signs have remained stable during the operation, and a live female infant was delivered successfully by cesarean section. The mother and daughter were safe at last. Written informed consent was provided by the patient for publication of this report with photos.created.

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