scholarly journals COMPARISON OF EFFICACY OF LEVOBUPIVACAINE IN TRANSVERSE ABDOMINIS PLANE BLOCK FOR POSTOPERATIVE ANALGESIA IN PATIENTS UNDERGOING CAESAREAN SECTION: A DOUBLE BLINDED, RANDOMIZED STUDY

2020 ◽  
pp. 1-3
Author(s):  
Praveen S ◽  
Shashank M
Keyword(s):  
Caesarean Section ◽  
Postoperative Analgesia ◽  
Randomized Study ◽  
Local Anaesthetics ◽  
Tap Block ◽  
Rescue Analgesia ◽  
Transverse Abdominis ◽  
Group A ◽  
Group B ◽  
Double Blinded

Background: Dexamethasone has a long and efficient glucocorticoid structure and presents anti-inflammatory properties. When used as an adjuvant to local anaesthetics, it prolongs the duration of analgesia. The aim of this study was to determine the effect of dexamethasone as an adjuvant to levobupivacaine in TAP block given to patients who underwent caesarean section. Materials & Methods: 70 patients posted for caesarean section under spinal anaesthesia were included in the study and divided into two groups. Group A received bilateral 30 ml 0.25% levobupivacaine and 2 ml dexamethasone(8mg). Group B received bilateral 30 ml 0.25% levobupivacaine and 2 ml 0.9% NaCl in a TAP block performed with ultrasonography. The time needed for the first rescue analgesia in the postoperative period was recorded. 24hr tramadol consumption & VAS was recorded. Results: Time for first analgesic administration (tramadol) was prolonged significantly in Group A (mean ± SD- 12.24 ± 1.22hrs) as compared to Group B (mean ± SD ‑ 8.37± 1.07 hrs), P < 0.0001. Tramadol requirement for 24hrs in Group A was 115.71± 16.89 mg and for Group B was 198.57± 22.64 mg, which was statistically significant (P < 0.0001). VAS was noted at 2, 4, 6, 8, 12, 18 and 24 h. VAS was greatly reduced in group A for the first 8–10 h post‑operatively as compared to patients in group B. CONCLUSIONS: Dexamethasone when used as an adjuvant to levobupivacaine in TAP block, enhances the duration of block & decreases opioid consumption in the post- caesarean section patients.

scholarly journals A Comparative Study between Analgesic Efficacy of Intrathecal Buprenorphine and USG-Guided Transversus Abdominis Plane Block in Patients Undergoing Cesarean Section under Spinal Anesthesia

2021 ◽  
Author(s):  
Rajashree Deelip Godbole ◽  
Abhilash Bandari ◽  
Jasmeet Gill ◽  
Shruti Tolambia ◽  
Yuvraj Hake ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Postoperative Analgesia ◽  
Analgesic Efficacy ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Hyperbaric Bupivacaine ◽  
Rescue Analgesia ◽  
Group A ◽  
Group B

Abstract Objective The aim of this study was to evaluate and compare the postoperative analgesic efficacy of intrathecal buprenorphine with ultrasonography (USG)-guided transversus abdominis plane (TAP) block in patients of cesarean section. Materials and Methods: Sixty American Society of Anesthesiologists grade I and II pregnant women aged between 20 and 40 years requiring lower segment cesarean section were included in this study. Study Design A prospective randomized comparative study. Study Groups Group A received intrathecal hyperbaric bupivacaine 0.5% 1.8 mL with 60 µg buprenorphine. Group B received intrathecal hyperbaric bupivacaine 0.5% 1.8 mL with 0.2 mL sterile normal saline and at the end of surgery USG-guided bilateral TAP block was given with 20 mL 0.25% bupivacaine on each side of abdomen. Results The mean ± standard deviation of time to first rescue analgesia in Group A and group B was 9.17 ± 0.64 hours and 5.59 ± 0.50 hours, respectively. Distribution of mean time to first rescue analgesia among the cases studied is significantly higher in group A compared with group B. The distribution of paracetamol and tramadol requirement in first 24 hours among the cases studied was significantly higher in group B compared with group A. Conclusion The addition of buprenorphine to intrathecal hyperbaric bupivacaine has advantages over USG-guided TAP block for postoperative analgesia after cesarean section—longer duration of postoperative analgesia, lower analgesic requirements over first 24 hours, and cost–effectiveness.

scholarly journals TAP Block in Postoperative Analgesia, A First Time Clinical Trial In Bangladesh

2016 ◽  
Vol 27 (1) ◽  
pp. 3-11
Author(s):  
Bidhan Paul ◽  
Debashis Banik ◽  
AKM Shamsul Alam
Keyword(s):  
Postoperative Analgesia ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Transversus Abdominis ◽  
Control Group ◽  
Tap Block ◽  
Analgesic Regimen ◽  
Time Period ◽  
Group A ◽  
Group B

Background: In perioperative care, a reliable pain management is a vital appeal. Over recent years, Transversus Abdominis Plane (TAP) block is introduced as an important component of multimodal analgesia.Objective: To evaluate efficacy of TAP block in postoperative analgesia for Total Abdominal Hysterectomy (TAH) with subarachnoid block (SAB) in comparison of morphine consumption and VAS score.Methods: 60 patients were randomly allocated into 2 groups (TAP group-A & control group-B). Standard SAB was applied to all patients for elective TAH. Immediate after operation classical TAP block was performed through both Lumber Triangle Of Petit (LTOP) of group A patients. Both groups were placed in Post Anesthesia Care Unit (PACU), arranged a common standard postoperative analgesic regimen for all, observed periodically and documented it accordingly in pre-designed data sheet.Results: TAP block prolonged the mean time of 1st required I/V morphine (TAP vs control, mean±SD 271.23±40.34 vs 195.33±22.16 min., p=0.001HS). Morphine requirement was also reduced (17.4±5.4 vs 26.2±4.4 mg, p=0.001HS). Pain VAS scores at rest and movement were also reduced at all time period (p? 0.01 to 0.001). There was no complication attributed to the TAP block.Conclusion: TAP block provided considerably effective postoperative analgesia in first 24 hours after major abdominal surgery like TAH.Journal of Bangladesh Society of Anaesthesiologists 2014; 27(1): 3-11

scholarly journals Effectiveness of Transversus Abdominis Plane Block for Postoperative Analgesia in Obstetric Cases Undergoing Caesarean Section

2019 ◽  
Vol 4 (2) ◽  
pp. 755-758
Author(s):  
Roshan Pradhan ◽  
Seema Kumari Mishra ◽  
Lalit Kumar Rajbanshi ◽  
Kanak Khanal ◽  
Batsalya Arjyal ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Pain Score ◽  
Postoperative Analgesia ◽  
Transversus Abdominis ◽  
Control Group ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Rescue Analgesia ◽  
Visual Analogue Pain ◽  
Significant Difference

Introduction: Transversus abdominis plane (TAP) block is a regional anesthesia that involves the infiltration of local anesthetic in between the internal oblique and transversus abdominis muscle plane. This block provides post-operative analgesia and reduces the requirement of opioids consumption. Objective: To assess the effectiveness of TAP block in providing postoperative analgesia in women undergoing caesarean section. Methodology: This was a hospital based prospective, comparative, cross sectional study conducted in 70 patients from 17th September 2018 to 17th February 2019 undergoing caesarean section under spinal anesthesia. Patients were divided into two groups. Group A patients received TAP block with 0.5% Ropivacaine versus Group B patients received injection paracetamol 1gm intravenous every 8 hourly as a standard and routine analgesic. At the end of the surgery, TAP block was performed by anesthesiologist and assessment of postoperative pain using a visual analogue pain score at every 1 hour, 3 hour, 6 hour, 12 hour and 24 hour by trained staffs at postoperative ward. Then, depending upon the severity of the pain injection fentanyl 1mcg/kg intravenous was given as rescue analgesia. Short assessment of patient satisfaction (SAPS) score was also assessed 24 hours postoperatively. Results: Compared to control group, in women who received TAP block, there was statistically significant reduction in pain at 3 hr, 6 hr, 24 hrs. However at 12 hrs there was no significant difference in the pain score. The cumulative fentanyl requirement was also significantly less in the TAP block group at all the time points.  Conclusion: The TAP block provided highly effective postoperative analgesia following caesarean section and reduces the fentanyl requirement in the first 24 hour.

scholarly journals Low Dose Bupivacaine plus Fentanyl in Subarachnoid Block for Caesarean Section

2016 ◽  
Vol 4 (1) ◽  
pp. 24-30
Author(s):  
Nasir Uddin Ahmed ◽  
Masuda Islam Khan ◽  
Aynul Islam Khan ◽  
AKM Akhtaruzzaman
Keyword(s):  
Blood Pressure ◽  
Caesarean Section ◽  
Systolic Blood Pressure ◽  
Postoperative Analgesia ◽  
Low Dose ◽  
Hyperbaric Bupivacaine ◽  
Haemodynamic Stability ◽  
Group A ◽  
Group B ◽  
Mean Time

Background: Spinal anaesthesia induced hypotension, a common problem during caesarean section, is associated with maternal nausea and vomiting and the risk of neonatal acidosis. Low dose local anaesthetic combined with opioids spinal anaesthesia better preserves maternal haemodynamic stability, resulting in equally efficacious anaesthesia.Objectives: To investigate whether this synergistic action could be used to provide effective anaesthesia while preventing hypotension during caesarean operation.Materials and method: This prospective study included 60 pregnant mothers scheduled for caesarean operation who were then divided into two groups (thirty in each). Group-A received a spinal injection of 12.5 mg of standardized 0.5% hyperbaric bupivacaine and group-B received 8 mg of 0.5% hyperbaric bupivacaine with 20 ?gm fentanyl. Hypotension was defined as the systolic blood pressure drops below 90 mm of Hg or a decrease of systolic blood pressure 25% from pre anaesthesia level and hypotension was treated with a bolus of 5 to 10 mg of intravenous ephedrine. The quality of anaesthesia and postoperative analgesia were evaluated.Results: The mean time required to reach peak sensory level was earlier in group-B than group-A and was statistically significant (p<0.05). The decrease in systolic blood pressure in group-A was significantly more than group-B (p<0.05) and vasopressor requirement was also significantly more in group-A compared to group-B (p<0.05). Mean time of two segment regression of sensory analgesia and complete sensory recovery was significantly early in group-B (p<0.05). Duration of motor recovery in group-B was significantly earlier (p<0.05). The duration of effective analgesia was significantly more in group-B (p<0.05).Conclusion: Low dose Bupivacaine with fentanyl provided excellent intraoperative sensory and motor blockade, haemodynamic stability, and effective postoperative analgesia for caesarean delivery.Delta Med Col J. Jan 2016 4(1): 24-30

scholarly journals A comparative study of caudal anesthesia with bupivacaine v/s bupivacaine with dexmedetomidine in lower abdominal surgeries in pediatric age group

Pain medicine ◽  
2021 ◽  
Vol 6 (3) ◽  
pp. 25-29
Author(s):  
Kishore Kumar N. ◽  
Sandeep Kadam
Keyword(s):  
Adverse Effect ◽  
Postoperative Analgesia ◽  
Rescue Analgesia ◽  
Pediatric Age Group ◽  
Respiratory Parameters ◽  
Caudal Anaesthesia ◽  
Significant Difference ◽  
Blinded Study ◽  
Group B ◽  
Double Blinded

Background: caudal anaesthesia has short­term effect. Alpha­2 adenoreceptors when used as adjuvant to local anaesthetic in children prolongs analgesic duration. The study is aimed to assess the efficacy of addition of dexme­detomidine with Bupivacaine in caudal block for extending postoperative analgesia and its safety profile in pediatric infra­umbilical surgeries.Method: the prospective interventional longitudinal double blinded study was conducted on 60 patients randomly divided into two groups by simple lottery method: group B who received (0.25 %) bupivacaine 1 ml/kg plus 1 ml nor­mal saline (NS), and those in group BD who received (0.25 %) bupivacaine 1 ml/kg plus 0.5 μg/kg dexmedetomidine in 1 ml NS. Post­surgery, both groups were compared in R studio v1.2.5001. Association between the adverse effect and other variables (age, gender, type of surgery, groups) were assessed by Multiple linear regression.Results: in group BD, duration of analgesia prolonged significantly (P < 0.05). In group BD, FLACC score at initial four hours and at 12th hour was significantly less (P < 0.05). Group B was more likely to receive high number of rescue analgesia (P = 0.0005; OR = 11.769). No significant difference was observed concerning hemodynamics, respiratory parameters and adverse effect between both groups (P > 0.05). Conclusion: in children, dexmedetomidine when used along with bupivacaine prolongs postoperative analgesia du­ration, without any significant side effects.

scholarly journals Tramadol or Nalbuphine; Which One is Superior for Analgesia in Post-Operative Period after Percutaneous Nephrolithotomy

2021 ◽  
Vol 15 (1) ◽  
pp. 51-54
Author(s):  
Muhammad Sheraz Javed ◽  
◽  
Ghulam Mehboob Subhani ◽  
Muhammad Akmal ◽  
Muhammad Irfan Munir ◽  
...  
Keyword(s):  
Pain Control ◽  
Rating Scale ◽  
Randomized Study ◽  
Rescue Analgesia ◽  
Post Operative Period ◽  
High Prevalence ◽  
Group A ◽  
Group B ◽  
Medical University ◽  
Pain Rating Scale

Background: Kidney stones has got high prevalence worldwide especially in our part of world and per-cutaneous nephrolithotomy (PCNL) is gold standard operative modality for renal stone management. Pain control after PCNL is the most important task for treating surgeon as effective pain control causes smooth patient recovery in post-operative period. For analgesia, many drugs can be used, out of which tramadol and nalbuphine always been in comparison for effective analgesic activity. Objective: To compare efficacy of tramadol and nalbuphine as potent analgesic in patients after PCNL. Study Design: A prospective randomized study. Settings: Department of Urology and Kidney Transplantation, Allied Hospital/Faisalabad Medical University, Faisalabad and Department of Urology, DHQ Hospital/Faisalabad Medical University, Faisalabad Pakistan. Duration: From September 2016 to September 2020 (4 Years). Methodology: 286 patients undergoing PCNL for either gender and sides enrolled in study according to inclusion and exclusion criteria. Patients divided into Group A (Administered with tramadol) and Group B (administered with nalbuphine) and patients evaluated for pain up to 48 hours after surgery using 11-point numerical pain rating scale rating from0-10 where 0 is no pain, 1-3 mild pain, 4-6 moderate pain, 7-9 severe pain and 10 as worst pain and use of rescue analgesia observed in either groups. Data obtained and statistical evaluation done. Results: 286 patients enrolled from age 15-75 years with mean age of 40.2 years. Among 286 patients, 161 were male and 125 were female patients. Both groups A and B having 143 patients each. Analysis showed that tramadol has superiority over nalbuphine and need of analgesia is more in patient given nalbuphine (118 vs 31) as maintenance analgesic agent in post-operative period after PCNL. Conclusion: This study showed that tramadol has superiority over nalbuphine for analgesia after PCNL.

Transversus abdominis plane block by landmark technique with ropivacaine versus bupivacaine for post-operative analgesia in patients undergoing lower segment caesarean section deliveries

2021 ◽  
Vol 8 (4) ◽  
pp. 551-555
Author(s):  
Aishwarya M Chavan ◽  
Geetha R Acharya ◽  
Jyoti V Kale ◽  
Nidhi R Dabral
Keyword(s):  
Patient Satisfaction ◽  
Caesarean Section ◽  
Postoperative Period ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Lower Segment ◽  
Rescue Analgesia ◽  
Lower Segment Caesarean Section ◽  
Group B

Transversus Abdominis Plane (TAP) Block is an efficacious abdominal field block which is widely used component of multimodal analgesia. Compare the efficacy of Inj. Ropivacaine 0.2% and Inj. Bupivacaine 0.2% when used in TAP block for post-operative analgesia in lower segment caesarean section deliveries(LSCS) done under spinal anaesthesia. Randomized double blinded prospective study conducted after institutional ethics committee in our institute. We have recruited sixty patients scheduled for an elective LSCS which were enrolled into two groups to receive TAP block with bupivacaine 0.2% 15ml Group B (n=30) versus ropivacaine 0.2% 15ml Group R (n=30) + dexamethasone 2mg bilaterally. TAP block was administered on completion of surgery. Primary objective was to compare time to rescue analgesia in postoperative period. Secondary Objectives wereto compare hemodynamic response during postoperative period, measure the intensity of pain using visual analogue scale (VAS), number of analgesic doses in first 24 hours, patient satisfaction with pain management and complications if any.SPSS software 16 version. Time for rescue analgesia was shorter in Group B (6.7 hour) than in Group R (9.47 hour) (p = 0.00). VAS was lower in Group R. Higher dose of analgesics was required in Group B (p=0.008). All this led to higher patient satisfaction score in Group R. This study concludes that 0.2% ropivacaine provided a longer duration of analgesia compared to 0.2% bupivacaine when used in TAP block for post-operative analgesia in LSCS deliveries.

scholarly journals A prospective randomized study to compare dexmedetomidine and dexamethasone as an adjunct to bupivacaine in transversus abdominis plane block for post-operative analgesia in caesarean delivery

2019 ◽  
Vol 8 (12) ◽  
pp. 4903
Author(s):  
Jitender Thakur ◽  
Bharti Gupta ◽  
Amit Gupta ◽  
Ravinder Kumar Verma ◽  
Anita Verma ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Randomized Study ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Ultrasound Guided ◽  
Subarachnoid Block ◽  
Dexamethasone Group ◽  
Group B ◽  
Patients Experience ◽  
To Receive

Background: Caesarean section is most frequently performed surgery worldwide. Patients experience moderate to severe pain in the first 48 hours post-operatively. Aim of this study was to evaluate the efficacy of dexmedetomidine and dexamethasone as an adjunct to bupivacaine in ultrasound guided TAP block for postoperative analgesia in patients of caesarean section.Methods: A total 120 ASA I and II patients undergoing elective and emergency caesarean section under subarachnoid block were randomly divided into three groups B, BDM, BDX to receive bupivacaine alone or dexmedetomidine or dexamethasone as an adjunct to bupivacaine in ultrasound guided TAP block. Postoperatively, the patients were evaluated for pain level at rest and on movement with a 10 cm visual analog scale (VAS) pain score (0 = no pain and 10 = worst pain), time to demand of first analgesic request, number of analgesic requirements, nausea or vomiting, sedation and patient satisfaction at 0 hours and at 2, 4, 6, 12, 18, and 24 hours.Results: VAS score was significantly higher in group B in comparison to BDM and BDX, and higher in BDX in comparison to group BDM. Mean duration of analgesia was significantly higher in group BDM in comparison to group B and BDX. Total number of rescue analgesic demands were significantly lower in group BDM in comparison to group B and BDX. Sedation score and satisfaction score was higher in group BDM as compared to group B and BDX.Conclusions: Addition of dexmedetomidine and dexamethasone as an adjunct to bupivacaine reduces postoperative pain, prolongs analgesia, decreases demand for additional analgesics and provides better maternal satisfaction as compared to plain bupivacaine group in TAP block in patients undergoing caesarean section under subarachnoid block. Among dexmedetomidine and dexamethasone, dexmedetomidine had prolonged analgesia as compared to dexamethasone group.

scholarly journals Prevention of White Flocculate Precipitation with Simethicone During Upper Gastrointestinal Endoscopy: A Double‐Blinded, Multi‐Center, Randomized Study

2020 ◽  
Author(s):  
Xueqin Chen ◽  
Ning Dai ◽  
Yanyong Deng ◽  
Xin Sun ◽  
Mingqing Zhang ◽  
...  
Keyword(s):  
Gastrointestinal Endoscopy ◽  
Randomized Study ◽  
Upper Gastrointestinal Endoscopy ◽  
Controlled Trials ◽  
Mixed Solution ◽  
Group A ◽  
Group B ◽  
Lukewarm Water ◽  
Double Blinded ◽  
Upper Gastrointestinal

Abstract Background: The reformulated simethicone emulsion from Berlin Chemical AG might develop white flocculate precipitation covering gastric mucosa when used before esophagogastroduodenoscopy (EGD). We aim to investigate whether combining reformulated simethicone emulsion with 5% NaHCO3 solution could prevent the development of white precipitation and improve visibility during EGD. Methods: Our study involved 523 patients. They were randomly assigned to two groups: In Group A patients received a warm mixed solution containing 30 ml 5% NaHCO3 solution and 15 ml reformulated simethicone emulsion. In Group B patients received 45 ml 40℃ lukewarm water. Visibility scores were recorded and analyzed. In addition, flush times, volume of flush water, overall time taken for EGD and complications during or after procedure were also recorded. Results: We found that no white precipitation was observed during EGD in Group A. Moreover, visibility scores in Group A were significantly lower (P < 0.01). Patients in Group A had fewer flush times (P < 0.01) and smaller volumes of flush water (P < 0.01). In addition, overall time taken for EGD procedure was significantly shorter in Group A (P < 0.01). The percentage of patients who had no adverse response is significantly higher in patients in Group A compared to Group B (P < 0.01). Conclusions: Premedication with mixed solution of 15ml reformulated simethicone emulsion and 30ml 5% NaHCO3 solution can prevent the development of white precipitation, substantially enhance mucosal visibility safely.Trial registration: The registered name of the trial is “Efficacy of using premedication with reformulated simethicone emulsion during upper gastrointestinal endoscopy examination”. Current Controlled Trials ChiCTR1900021689, as well as the date of registration is 11 September 2019. Retrospectively registered, http://www.medresman.org.cn/uc/sindex.aspx.

scholarly journals Transverses Abdominis Plane Block Versus Trocar Site Infiltration in Gynecologic Laparoscopy An Observational Study

2020 ◽  
Vol 8 (7) ◽  
pp. 487-493
Author(s):  
Insha Qureshi ◽  
Kaiser Ahmad ◽  
Omar Masood
Keyword(s):  
Laparoscopic Surgery ◽  
Observational Study ◽  
P Value ◽  
Tap Block ◽  
Trocar Site ◽  
Rescue Analgesia ◽  
Analgesic Regimen ◽  
Group A ◽  
Gynecologic Laparoscopy ◽  
Group B

Background and Aims: Laparoscopic surgery is nowadays gold standard procedure undertaken for various surgical procedures and people prefer laparoscopic approach but the effective analgesic regimen for such patients has not been devised and anaesthesiologists prefer multimodal regimes. Despite the minimally invasive nature of this procedure, patients experience a considerable amount of pain in the first 24 h postoperatively. In our study, we are comparing the  degrees of pain relief with TAP block vs Trocar site infiltration using VAS, the duration of postoperative analgesia achieve by   TAP block and compare it with Trocar site infiltration and  total consumption of rescue analgesia consumed in first 24 hours postoperatively in patients undergoing gynaecologic  Laparoscopic surgeries. Methods: After obtaining approval from the hospital Ethical committee and written informed consent from patients, this observational study was undertaken at the Government Lalla Ded Hospital which is one of the associated hospitals of Government Medical College, Srinagar during routine hours on 100 patients posted for elective Gynecological Laparoscopic surgery under general anesthesia.  A total sample size of 100 patients (n= 50) for each group was calculated using PASSE (power and sample estimation) for study design and analysis. Assuming 30% improvement in pain score with error of 0.05 (i.e. 5% of DOF   (degree of freedom). Results: Visual analogue scale at different time intervals were statistically significantly lower at all times in Group A than Group B p-value (p<0.05). The time to first request for analgesia was higher in group A as compared to group B   with statistical difference among the study groups  p-value (p<0.05). Conclusion: As a promising novel post-operative pain treatment procedure, TAP block is cost effective and one of the safest, easiest and the most effective supplemental techniques as part of analgesic regimen. It improves pain scores in gynecologic laparoscopy.

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