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.

Ultrasound Guided Quadratus Lumborum Block versus Transversus Abdominis Plane Block in Post-Operative Pain Management after Cesarean Section

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Omar Mohamed Taha Elsafty ◽  
Hanan Mahmoud Farag Awad ◽  
Mohamed Saleh Ahmed ◽  
Ahmed Elkholy Mahdy
Keyword(s):  
Postoperative Pain ◽  
Cesarean Section ◽  
Pain Control ◽  
Early Mobilization ◽  
Transversus Abdominis Plane Block ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Quadratus Lumborum

Abstract Background Cesarean section rate increased those days and postoperative pain control. The goal of postoperative pain management is provision of comfort, early mobilization and improved respiratory function without causing inadequate sedation and respiratory compromise, which can be achieved through using multimodal analgesic therapy, preference for regional techniques, avoidance of sedatives, non-invasive ventilation with supplemental oxygen and early mobilization. Objectives The aim of this study was to assess the analgesic efficacy of ultrasound-guided trans-muscular QLB compared with TAP block after cesarean section surgeryperiod regarding pain relief, provision of comfort, and improved respiratory functions. Patients and Methods After approval of anesthesiology department scientific and ethical committees in Ain Shams University Hospitals, female patients were included in the study, and were divided into three groups (n = 20; each); group QLB and group TAP. Group QLB: Patients (n = 20) of this group received bilateral ultrasound-guided QLB after induction of general anesthesia using 0.2 ml/kg bupivacaine 0.125%, Group TAP: Patients (n = 20) of this group received bilateral ultrasound-guided TAP block after induction of general anesthesia using 0.2 ml/kg bupivacaine 0.125%. Results The current study also measured and compared postoperative VAS score and firs time to rescue analgesia and the total amount of opioid (pethidine) given in the first 24 hours with the standard deviation for each of the two groups studied we found that TAP patients had the highest values compared to the QLB group. This is mainly due to the extension of the local anesthetic agent beyond the transverse abdominal plane to the thoracic paravertebral space, which then results in more analgesia, even somatic and visceral pain control. Conclusion Quadratus lumborum block was the most effective technique in providing analgesia after cesarean section without associated hemodynamic instability in comparison to transversus abdominis plane block and even more time covering to rescue opioid.

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