Ultrasound-guided transversus abdominis plane block for analgesia after Caesarean delivery
The landmark-guided transversus abdominis plane (TAP) block is an effective method of providing postoperative analgesia in patients undergoing lower abdominal surgery. We evaluated the analgesic efficacy of the ultrasound (US)-guided TAP block in patients undergoing Caesarean delivery. A randomized,...
Gespeichert in:
| Veröffentlicht in: | British journal of anaesthesia : BJA 2009-11, Vol.103 (5), p.726-730 |
|---|---|
| Hauptverfasser: | , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 730 |
|---|---|
| container_issue | 5 |
| container_start_page | 726 |
| container_title | British journal of anaesthesia : BJA |
| container_volume | 103 |
| creator | Belavy, D. Cowlishaw, P.J. Howes, M. Phillips, F. |
| description | The landmark-guided transversus abdominis plane (TAP) block is an effective method of providing postoperative analgesia in patients undergoing lower abdominal surgery. We evaluated the analgesic efficacy of the ultrasound (US)-guided TAP block in patients undergoing Caesarean delivery.
A randomized, double-blind, placebo-controlled trial was performed at a tertiary maternity hospital. Fifty women undergoing Caesarean delivery received bilateral US-guided TAP blocks with either ropivacaine 0.5% or saline. All participants received a spinal anaesthetic with bupivacaine and fentanyl, followed by postoperative acetaminophen, non-steroidal anti-inflammatory drugs, and patient-controlled i.v. morphine without long-acting intrathecal opioids. Each patient was assessed 24 h after delivery for morphine usage, average pain score, nausea, vomiting, pruritus, drowsiness, and satisfaction with pain relief.
Forty-seven participants completed the trial, 23 in the active group and 24 in the placebo group. Total morphine use in 24 h was reduced in the active group (median 18.0 mg) compared with the placebo group (median 31.5 mg, P |
| doi_str_mv | 10.1093/bja/aep235 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_733600728</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/bja/aep235</oup_id><els_id>S0007091217339120</els_id><sourcerecordid>733600728</sourcerecordid><originalsourceid>FETCH-LOGICAL-c465t-56270f7684470a13877422b04aa46b558999f470dd2f63083317536cece797fa3</originalsourceid><addsrcrecordid>eNp90N9r1TAUB_AgirtOX_wDpC8iCHX50eY0j3LRTTYU0aHsJZwmpyNbb9sl7XD_vRm9bC_iUwjnk3NOvoy9FvyD4EYdtVd4hDRJVT9hG1GBKDWAeMo2nHMouRHygL1I6YpzAdLUz9mBMJBLoDfs4ryfI6ZxGXx5uQRPvsj3Id1STEsqsPXjLgwhFVOPAxVtP7rrohtjgQP2l5QCFtjNFIstUsJIOBSe-pCf371kzzrsE73an4fs_POnn9uT8uzb8Zftx7PSVbqey1pL4B3opqqAo1ANQCVlyyvESrd13RhjulzyXnZa8UYpAbXSjhyBgQ7VIXu39p3ieLNQmu0uJEf9_cLjkiwopfNvZZPl-1W6OKYUqbNTDDuMd1Zwex-lzVHaNcqM3-zbLu2O_CPdZ5fB2z3A5LDvcmwupAcnpaiaphaPblym_w8sVxfSTH8eJMZrq0FBbU9-X9jvP76eGvh1ao-zr1ZPOdzbQNEmF2hw5EMkN1s_hn-N-QsPvaqS</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>733600728</pqid></control><display><type>article</type><title>Ultrasound-guided transversus abdominis plane block for analgesia after Caesarean delivery</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Belavy, D. ; Cowlishaw, P.J. ; Howes, M. ; Phillips, F.</creator><creatorcontrib>Belavy, D. ; Cowlishaw, P.J. ; Howes, M. ; Phillips, F.</creatorcontrib><description>The landmark-guided transversus abdominis plane (TAP) block is an effective method of providing postoperative analgesia in patients undergoing lower abdominal surgery. We evaluated the analgesic efficacy of the ultrasound (US)-guided TAP block in patients undergoing Caesarean delivery.
A randomized, double-blind, placebo-controlled trial was performed at a tertiary maternity hospital. Fifty women undergoing Caesarean delivery received bilateral US-guided TAP blocks with either ropivacaine 0.5% or saline. All participants received a spinal anaesthetic with bupivacaine and fentanyl, followed by postoperative acetaminophen, non-steroidal anti-inflammatory drugs, and patient-controlled i.v. morphine without long-acting intrathecal opioids. Each patient was assessed 24 h after delivery for morphine usage, average pain score, nausea, vomiting, pruritus, drowsiness, and satisfaction with pain relief.
Forty-seven participants completed the trial, 23 in the active group and 24 in the placebo group. Total morphine use in 24 h was reduced in the active group (median 18.0 mg) compared with the placebo group (median 31.5 mg, P<0.05). The active group reported improved satisfaction with their pain relief measured by visual analogue scale compared with the placebo group (median 96 vs 77 mm, P=0.008). Fewer patients required antiemetics in the active group (P=0.03). There were no local complications attributable to the TAP block, but one participant had an anaphylactoid reaction after ropivacaine injection.
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.</description><identifier>ISSN: 0007-0912</identifier><identifier>EISSN: 1471-6771</identifier><identifier>DOI: 10.1093/bja/aep235</identifier><identifier>PMID: 19700776</identifier><identifier>CODEN: BJANAD</identifier><language>eng</language><publisher>Oxford: Elsevier Ltd</publisher><subject>Abdominal Muscles - diagnostic imaging ; Adult ; anaesthesia ; anaesthesia, obstetric ; anaesthetic techniques ; anaesthetic techniques, regional ; Analgesia, Obstetrical - methods ; Analgesia, Patient-Controlled - methods ; Analgesics, Opioid - administration & dosage ; Anesthesia ; Anesthesia, Obstetrical - methods ; Anesthesia, Spinal ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Cesarean Section ; Combined Modality Therapy ; Double-Blind Method ; Drug Administration Schedule ; Female ; Humans ; Medical sciences ; Morphine - administration & dosage ; Nerve Block - adverse effects ; Nerve Block - methods ; obstetric ; Pain, Postoperative - prevention & control ; Pregnancy ; regional ; Ultrasonography, Interventional - methods ; Young Adult</subject><ispartof>British journal of anaesthesia : BJA, 2009-11, Vol.103 (5), p.726-730</ispartof><rights>2009 British Journal of Anaesthesia</rights><rights>The Author [2009]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournal.org 2009</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c465t-56270f7684470a13877422b04aa46b558999f470dd2f63083317536cece797fa3</citedby><cites>FETCH-LOGICAL-c465t-56270f7684470a13877422b04aa46b558999f470dd2f63083317536cece797fa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22148851$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19700776$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Belavy, D.</creatorcontrib><creatorcontrib>Cowlishaw, P.J.</creatorcontrib><creatorcontrib>Howes, M.</creatorcontrib><creatorcontrib>Phillips, F.</creatorcontrib><title>Ultrasound-guided transversus abdominis plane block for analgesia after Caesarean delivery</title><title>British journal of anaesthesia : BJA</title><addtitle>Br J Anaesth</addtitle><addtitle>Br J Anaesth</addtitle><description>The landmark-guided transversus abdominis plane (TAP) block is an effective method of providing postoperative analgesia in patients undergoing lower abdominal surgery. We evaluated the analgesic efficacy of the ultrasound (US)-guided TAP block in patients undergoing Caesarean delivery.
A randomized, double-blind, placebo-controlled trial was performed at a tertiary maternity hospital. Fifty women undergoing Caesarean delivery received bilateral US-guided TAP blocks with either ropivacaine 0.5% or saline. All participants received a spinal anaesthetic with bupivacaine and fentanyl, followed by postoperative acetaminophen, non-steroidal anti-inflammatory drugs, and patient-controlled i.v. morphine without long-acting intrathecal opioids. Each patient was assessed 24 h after delivery for morphine usage, average pain score, nausea, vomiting, pruritus, drowsiness, and satisfaction with pain relief.
Forty-seven participants completed the trial, 23 in the active group and 24 in the placebo group. Total morphine use in 24 h was reduced in the active group (median 18.0 mg) compared with the placebo group (median 31.5 mg, P<0.05). The active group reported improved satisfaction with their pain relief measured by visual analogue scale compared with the placebo group (median 96 vs 77 mm, P=0.008). Fewer patients required antiemetics in the active group (P=0.03). There were no local complications attributable to the TAP block, but one participant had an anaphylactoid reaction after ropivacaine injection.
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.</description><subject>Abdominal Muscles - diagnostic imaging</subject><subject>Adult</subject><subject>anaesthesia</subject><subject>anaesthesia, obstetric</subject><subject>anaesthetic techniques</subject><subject>anaesthetic techniques, regional</subject><subject>Analgesia, Obstetrical - methods</subject><subject>Analgesia, Patient-Controlled - methods</subject><subject>Analgesics, Opioid - administration & dosage</subject><subject>Anesthesia</subject><subject>Anesthesia, Obstetrical - methods</subject><subject>Anesthesia, Spinal</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Cesarean Section</subject><subject>Combined Modality Therapy</subject><subject>Double-Blind Method</subject><subject>Drug Administration Schedule</subject><subject>Female</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Morphine - administration & dosage</subject><subject>Nerve Block - adverse effects</subject><subject>Nerve Block - methods</subject><subject>obstetric</subject><subject>Pain, Postoperative - prevention & control</subject><subject>Pregnancy</subject><subject>regional</subject><subject>Ultrasonography, Interventional - methods</subject><subject>Young Adult</subject><issn>0007-0912</issn><issn>1471-6771</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90N9r1TAUB_AgirtOX_wDpC8iCHX50eY0j3LRTTYU0aHsJZwmpyNbb9sl7XD_vRm9bC_iUwjnk3NOvoy9FvyD4EYdtVd4hDRJVT9hG1GBKDWAeMo2nHMouRHygL1I6YpzAdLUz9mBMJBLoDfs4ryfI6ZxGXx5uQRPvsj3Id1STEsqsPXjLgwhFVOPAxVtP7rrohtjgQP2l5QCFtjNFIstUsJIOBSe-pCf371kzzrsE73an4fs_POnn9uT8uzb8Zftx7PSVbqey1pL4B3opqqAo1ANQCVlyyvESrd13RhjulzyXnZa8UYpAbXSjhyBgQ7VIXu39p3ieLNQmu0uJEf9_cLjkiwopfNvZZPl-1W6OKYUqbNTDDuMd1Zwex-lzVHaNcqM3-zbLu2O_CPdZ5fB2z3A5LDvcmwupAcnpaiaphaPblym_w8sVxfSTH8eJMZrq0FBbU9-X9jvP76eGvh1ao-zr1ZPOdzbQNEmF2hw5EMkN1s_hn-N-QsPvaqS</recordid><startdate>20091101</startdate><enddate>20091101</enddate><creator>Belavy, D.</creator><creator>Cowlishaw, P.J.</creator><creator>Howes, M.</creator><creator>Phillips, F.</creator><general>Elsevier Ltd</general><general>Oxford University Press</general><scope>6I.</scope><scope>AAFTH</scope><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20091101</creationdate><title>Ultrasound-guided transversus abdominis plane block for analgesia after Caesarean delivery</title><author>Belavy, D. ; Cowlishaw, P.J. ; Howes, M. ; Phillips, F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c465t-56270f7684470a13877422b04aa46b558999f470dd2f63083317536cece797fa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Abdominal Muscles - diagnostic imaging</topic><topic>Adult</topic><topic>anaesthesia</topic><topic>anaesthesia, obstetric</topic><topic>anaesthetic techniques</topic><topic>anaesthetic techniques, regional</topic><topic>Analgesia, Obstetrical - methods</topic><topic>Analgesia, Patient-Controlled - methods</topic><topic>Analgesics, Opioid - administration & dosage</topic><topic>Anesthesia</topic><topic>Anesthesia, Obstetrical - methods</topic><topic>Anesthesia, Spinal</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Cesarean Section</topic><topic>Combined Modality Therapy</topic><topic>Double-Blind Method</topic><topic>Drug Administration Schedule</topic><topic>Female</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Morphine - administration & dosage</topic><topic>Nerve Block - adverse effects</topic><topic>Nerve Block - methods</topic><topic>obstetric</topic><topic>Pain, Postoperative - prevention & control</topic><topic>Pregnancy</topic><topic>regional</topic><topic>Ultrasonography, Interventional - methods</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Belavy, D.</creatorcontrib><creatorcontrib>Cowlishaw, P.J.</creatorcontrib><creatorcontrib>Howes, M.</creatorcontrib><creatorcontrib>Phillips, F.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of anaesthesia : BJA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Belavy, D.</au><au>Cowlishaw, P.J.</au><au>Howes, M.</au><au>Phillips, F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ultrasound-guided transversus abdominis plane block for analgesia after Caesarean delivery</atitle><jtitle>British journal of anaesthesia : BJA</jtitle><stitle>Br J Anaesth</stitle><addtitle>Br J Anaesth</addtitle><date>2009-11-01</date><risdate>2009</risdate><volume>103</volume><issue>5</issue><spage>726</spage><epage>730</epage><pages>726-730</pages><issn>0007-0912</issn><eissn>1471-6771</eissn><coden>BJANAD</coden><abstract>The landmark-guided transversus abdominis plane (TAP) block is an effective method of providing postoperative analgesia in patients undergoing lower abdominal surgery. We evaluated the analgesic efficacy of the ultrasound (US)-guided TAP block in patients undergoing Caesarean delivery.
A randomized, double-blind, placebo-controlled trial was performed at a tertiary maternity hospital. Fifty women undergoing Caesarean delivery received bilateral US-guided TAP blocks with either ropivacaine 0.5% or saline. All participants received a spinal anaesthetic with bupivacaine and fentanyl, followed by postoperative acetaminophen, non-steroidal anti-inflammatory drugs, and patient-controlled i.v. morphine without long-acting intrathecal opioids. Each patient was assessed 24 h after delivery for morphine usage, average pain score, nausea, vomiting, pruritus, drowsiness, and satisfaction with pain relief.
Forty-seven participants completed the trial, 23 in the active group and 24 in the placebo group. Total morphine use in 24 h was reduced in the active group (median 18.0 mg) compared with the placebo group (median 31.5 mg, P<0.05). The active group reported improved satisfaction with their pain relief measured by visual analogue scale compared with the placebo group (median 96 vs 77 mm, P=0.008). Fewer patients required antiemetics in the active group (P=0.03). There were no local complications attributable to the TAP block, but one participant had an anaphylactoid reaction after ropivacaine injection.
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.</abstract><cop>Oxford</cop><pub>Elsevier Ltd</pub><pmid>19700776</pmid><doi>10.1093/bja/aep235</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0007-0912 |
| ispartof | British journal of anaesthesia : BJA, 2009-11, Vol.103 (5), p.726-730 |
| issn | 0007-0912 1471-6771 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_733600728 |
| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Abdominal Muscles - diagnostic imaging Adult anaesthesia anaesthesia, obstetric anaesthetic techniques anaesthetic techniques, regional Analgesia, Obstetrical - methods Analgesia, Patient-Controlled - methods Analgesics, Opioid - administration & dosage Anesthesia Anesthesia, Obstetrical - methods Anesthesia, Spinal Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Cesarean Section Combined Modality Therapy Double-Blind Method Drug Administration Schedule Female Humans Medical sciences Morphine - administration & dosage Nerve Block - adverse effects Nerve Block - methods obstetric Pain, Postoperative - prevention & control Pregnancy regional Ultrasonography, Interventional - methods Young Adult |
| title | Ultrasound-guided transversus abdominis plane block for analgesia after Caesarean delivery |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-03T07%3A08%3A47IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Ultrasound-guided%20transversus%20abdominis%20plane%20block%20for%20analgesia%20after%20Caesarean%20delivery&rft.jtitle=British%20journal%20of%20anaesthesia%20:%20BJA&rft.au=Belavy,%20D.&rft.date=2009-11-01&rft.volume=103&rft.issue=5&rft.spage=726&rft.epage=730&rft.pages=726-730&rft.issn=0007-0912&rft.eissn=1471-6771&rft.coden=BJANAD&rft_id=info:doi/10.1093/bja/aep235&rft_dat=%3Cproquest_cross%3E733600728%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=733600728&rft_id=info:pmid/19700776&rft_oup_id=10.1093/bja/aep235&rft_els_id=S0007091217339120&rfr_iscdi=true |