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Published in: The Journal of Obstetrics and Gynecology of India 4/2019

01-08-2019 | Ultrasound | Original Article

Evaluate the Feasibility of Surgical Transversus Abdominis Plane Block for Postoperative Analgesia After Cesarean Section

Authors: Aniket Kakade, Girija Wagh

Published in: The Journal of Obstetrics and Gynecology of India | Issue 4/2019

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Abstract

Background

Transversus abdominis plane (TAP) block is a fascial plane block providing postoperative analgesia after lower abdominal surgeries including Cesarean section. Conventionally, it is administered under ultrasound guidance or by blind technique. We studied a novel transperitoneal surgical TAP block for providing safe and effective analgesia after Cesarean section through transverse incision.

Methods

A hundred patients who fulfilled the inclusion criteria were included in the study after obtaining informed written consent. They were randomized in two groups: Group A with surgical TAP block and Group B without TAP block as control. Surgical TAP block was administered by transperitoneal route before the closure of peritoneum with 0.25% bupivacaine (dose adjusted with weight of the patient), and visual analogue score was assessed by a blind assessor. Time for rescue analgesia was noted and analyzed with the ‘two independent sample t test.’

Results

The duration of postoperative analgesia in hours was significantly longer in the TAP block group compared with the control group (5.14 ± 1.63 vs 2.61 ± 0.89, p < 0.001). There was no reported complication of the surgical technique or any adverse effect of the used drug.

Conclusion

Surgical TAP block via the transperitoneal route is a safe, easy and effective mode of providing postoperative analgesia after Cesarean section. This technique does not need any costly specialist equipment, overcomes the technical limitations of ultrasound-guided TAP block and can be used in obese patients also. It has almost no side effects, and the technique can be easily mastered.
Literature
1.
go back to reference Dwivedi D, Bhatnagar V, Goje HK, et al. Transversus abdominis plane block: a multimodal analgesia technique—our experience. J Mar Med Soc. 2017;19:38–42.CrossRef Dwivedi D, Bhatnagar V, Goje HK, et al. Transversus abdominis plane block: a multimodal analgesia technique—our experience. J Mar Med Soc. 2017;19:38–42.CrossRef
2.
go back to reference Owen D, Harrod I, Ford J, et al. The surgical transversus abdominis plane block—a novel approach for performing an established technique. BJOG. 2011;118:24–7.CrossRefPubMed Owen D, Harrod I, Ford J, et al. The surgical transversus abdominis plane block—a novel approach for performing an established technique. BJOG. 2011;118:24–7.CrossRefPubMed
3.
go back to reference Birnbach DJ, Browne IM. Anesthesia for obstetrics. In: Miller RD, editor. Miller’s anesthesia. Philadelphia: Elsevier Churchill Livingstone; 2005. p. 2307–44. Birnbach DJ, Browne IM. Anesthesia for obstetrics. In: Miller RD, editor. Miller’s anesthesia. Philadelphia: Elsevier Churchill Livingstone; 2005. p. 2307–44.
4.
go back to reference Danelli G, Zangrillo A, Nucera D, et al. The minimum effective dose of 0.5% hyperbaric spinal bupivacaine for cesarean section. Minerva Anestesiol. 2001;67:573–7.PubMed Danelli G, Zangrillo A, Nucera D, et al. The minimum effective dose of 0.5% hyperbaric spinal bupivacaine for cesarean section. Minerva Anestesiol. 2001;67:573–7.PubMed
5.
go back to reference Srivastava U, Verma S, Singh TK, et al. Efficacy of trans abdominis plane block for post cesarean delivery analgesia: a double-blind, randomized trial. Saudi J Anaesth. 2015;9:298–302.CrossRefPubMedPubMedCentral Srivastava U, Verma S, Singh TK, et al. Efficacy of trans abdominis plane block for post cesarean delivery analgesia: a double-blind, randomized trial. Saudi J Anaesth. 2015;9:298–302.CrossRefPubMedPubMedCentral
6.
go back to reference Hebbard P, Fujiwara Y, Shibata Y, et al. Ultrasound- guided transversus abdominis plane (TAP) block. Anaesth Intensive Care. 2007;35:616–7.PubMed Hebbard P, Fujiwara Y, Shibata Y, et al. Ultrasound- guided transversus abdominis plane (TAP) block. Anaesth Intensive Care. 2007;35:616–7.PubMed
7.
go back to reference Belavy D, Cowlishaw PJ, Howes M, et al. Ultrasound-guided transversus abdominis plane block for analgesia after Cesarean delivery. Br J Anaesth. 2009;103:726–30.CrossRefPubMed Belavy D, Cowlishaw PJ, Howes M, et al. Ultrasound-guided transversus abdominis plane block for analgesia after Cesarean delivery. Br J Anaesth. 2009;103:726–30.CrossRefPubMed
8.
go back to reference Tan TT, Teoh WH, Woo DC, et al. A randomized trial of the analgesic efficacy of ultrasound guided transversus abdominis plane block after cesarean delivery under general anesthesia. Eur J Anaesthesiol. 2012;29:88–94.CrossRefPubMed Tan TT, Teoh WH, Woo DC, et al. A randomized trial of the analgesic efficacy of ultrasound guided transversus abdominis plane block after cesarean delivery under general anesthesia. Eur J Anaesthesiol. 2012;29:88–94.CrossRefPubMed
9.
10.
go back to reference Leung AY. Postoperative pain management in obstetric anesthesia—new challenges and solutions. J Clin Anesth. 2004;16:57–65.CrossRefPubMed Leung AY. Postoperative pain management in obstetric anesthesia—new challenges and solutions. J Clin Anesth. 2004;16:57–65.CrossRefPubMed
11.
go back to reference Siddiqui KM, Ali MA, Ullah H. Comparison of spinal anesthesia dosage based on height and weight versus height alone in patients undergoing elective cesarean section. Korean J Anesthesiol. 2016;69:143–8.CrossRefPubMedPubMedCentral Siddiqui KM, Ali MA, Ullah H. Comparison of spinal anesthesia dosage based on height and weight versus height alone in patients undergoing elective cesarean section. Korean J Anesthesiol. 2016;69:143–8.CrossRefPubMedPubMedCentral
13.
go back to reference De Oliveira GS, Jr Castro-Alves LJ, Nader A, et al. Transversus abdominis plane block to ameliorate postoperative pain outcomes after laparoscopic surgery: a meta-analysis of randomized controlled trials. Anesth Analg. 2014;118:454–63.CrossRefPubMed De Oliveira GS, Jr Castro-Alves LJ, Nader A, et al. Transversus abdominis plane block to ameliorate postoperative pain outcomes after laparoscopic surgery: a meta-analysis of randomized controlled trials. Anesth Analg. 2014;118:454–63.CrossRefPubMed
14.
go back to reference Petersen PL, Mathiesen O, Troup H, et al. The transverses abdominis plane block: a valuable option of postoperative analgesia? A topical review. Acta Anaesthesiol Scand. 2010;54:529–35.CrossRefPubMed Petersen PL, Mathiesen O, Troup H, et al. The transverses abdominis plane block: a valuable option of postoperative analgesia? A topical review. Acta Anaesthesiol Scand. 2010;54:529–35.CrossRefPubMed
15.
go back to reference Ramya Parameswari A, Udayakumar P. Comparison of efficacy of bupivacaine with dexmedetomidine versus bupivacaine alone for transversus abdominis plane block for post-operative analgesia in patients undergoing elective caesarean section. J Obstet Gynaecol India. 2017;68:98–103.CrossRefPubMedPubMedCentral Ramya Parameswari A, Udayakumar P. Comparison of efficacy of bupivacaine with dexmedetomidine versus bupivacaine alone for transversus abdominis plane block for post-operative analgesia in patients undergoing elective caesarean section. J Obstet Gynaecol India. 2017;68:98–103.CrossRefPubMedPubMedCentral
16.
go back to reference Sachdeva J, Sinha A. Randomized controlled trial to study the effect of dexamethasone as additive to ropivacaine on duration of ultrasound-guided transversus abdominis plane block in cesarean section. Indian J Pain. 2016;30:181–5.CrossRef Sachdeva J, Sinha A. Randomized controlled trial to study the effect of dexamethasone as additive to ropivacaine on duration of ultrasound-guided transversus abdominis plane block in cesarean section. Indian J Pain. 2016;30:181–5.CrossRef
Metadata
Title
Evaluate the Feasibility of Surgical Transversus Abdominis Plane Block for Postoperative Analgesia After Cesarean Section
Authors
Aniket Kakade
Girija Wagh
Publication date
01-08-2019
Publisher
Springer India
Published in
The Journal of Obstetrics and Gynecology of India / Issue 4/2019
Print ISSN: 0971-9202
Electronic ISSN: 0975-6434
DOI
https://doi.org/10.1007/s13224-019-01241-3

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