Comparison of transversus abdominis plane block vs spinal morphine for pain relief after Caesarean section.

Hdl Handle:
http://hdl.handle.net/10147/135632
Title:
Comparison of transversus abdominis plane block vs spinal morphine for pain relief after Caesarean section.
Authors:
McMorrow, R C N; Ni Mhuircheartaigh, R J; Ahmed, K A; Aslani, A; Ng, S-C; Conrick-Martin, I; Dowling, J J; Gaffney, A; Loughrey, J P R; McCaul, C L
Affiliation:
Department of Anesthesia, Rotunda Hospital, Parnell Square, Dublin 1, Ireland.
Citation:
Comparison of transversus abdominis plane block vs spinal morphine for pain relief after Caesarean section. 2011, 106 (5):706-12 Br J Anaesth
Journal:
British journal of anaesthesia
Issue Date:
May-2011
URI:
http://hdl.handle.net/10147/135632
DOI:
10.1093/bja/aer061
PubMed ID:
21498494
Additional Links:
http://www.ncbi.nlm.nih.gov/pubmed/21498494
Abstract:
Transversus abdominis plane (TAP) block is an alternative to spinal morphine for analgesia after Caesarean section but there are few data on its comparative efficacy. We compared the analgesic efficacy of the TAP block with and without spinal morphine after Caesarean section in a prospective, randomized, double-blinded placebo-controlled trial.; Eighty patients were randomized to one of four groups to receive (in addition to spinal anaesthesia) either spinal morphine 100 µg (S(M)) or saline (S(S)) and a postoperative bilateral TAP block with either bupivacaine (T(LA)) 2 mg kg(-1) or saline (T(S)).; Pain on movement and early morphine consumption were lowest in groups receiving spinal morphine and was not improved by TAP block. The rank order of median pain scores on movement at 6 h was: S(M)T(LA) (20 mm)<S(M)T(S) (27.5 mm)<S(S)T(S) (51.5 mm)<S(S)T(LA) (52.0 mm) (P<0.05, highest vs lowest). The rank order of median morphine consumption at 6 h was: S(M)T(S) (4.0 mg)<S(M)T(LA) (5.0 mg)<S(S)T(LA) (8.0 mg)<S(S)T(S) (12.0 mg) and at 24 h was: S(M)T(LA) (5.0 mg)<S(M)T(S) (6.0 mg)<S(S)T(S) (9.5 mg)<S(S)T(LA) (15.0 mg) (P<0.05, highest vs lowest). Sedation scores and patient satisfaction did not differ between groups. Anti-emetic use and pruritus were highest in the S(M)T(LA) group.; Spinal morphine-but not TAP block-improved analgesia after Caesarean section. The addition of TAP block with bupivacaine 2 mg kg(-1) to spinal morphine did not further improve analgesia.
Item Type:
Article
Language:
en
MeSH:
Abdominal Muscles; Adult; Analgesia, Obstetrical; Analgesics, Opioid; Anesthesia, Obstetrical; Anesthesia, Spinal; Antiemetics; Cesarean Section; Double-Blind Method; Drug Administration Schedule; Female; Humans; Morphine; Nerve Block; Pain Measurement; Pain, Postoperative; Patient Satisfaction; Pregnancy; Prospective Studies; Pruritus
ISSN:
1471-6771

Full metadata record

DC FieldValue Language
dc.contributor.authorMcMorrow, R C Nen
dc.contributor.authorNi Mhuircheartaigh, R Jen
dc.contributor.authorAhmed, K Aen
dc.contributor.authorAslani, Aen
dc.contributor.authorNg, S-Cen
dc.contributor.authorConrick-Martin, Ien
dc.contributor.authorDowling, J Jen
dc.contributor.authorGaffney, Aen
dc.contributor.authorLoughrey, J P Ren
dc.contributor.authorMcCaul, C Len
dc.date.accessioned2011-07-08T10:34:50Z-
dc.date.available2011-07-08T10:34:50Z-
dc.date.issued2011-05-
dc.identifier.citationComparison of transversus abdominis plane block vs spinal morphine for pain relief after Caesarean section. 2011, 106 (5):706-12 Br J Anaesthen
dc.identifier.issn1471-6771-
dc.identifier.pmid21498494-
dc.identifier.doi10.1093/bja/aer061-
dc.identifier.urihttp://hdl.handle.net/10147/135632-
dc.description.abstractTransversus abdominis plane (TAP) block is an alternative to spinal morphine for analgesia after Caesarean section but there are few data on its comparative efficacy. We compared the analgesic efficacy of the TAP block with and without spinal morphine after Caesarean section in a prospective, randomized, double-blinded placebo-controlled trial.-
dc.description.abstractEighty patients were randomized to one of four groups to receive (in addition to spinal anaesthesia) either spinal morphine 100 µg (S(M)) or saline (S(S)) and a postoperative bilateral TAP block with either bupivacaine (T(LA)) 2 mg kg(-1) or saline (T(S)).-
dc.description.abstractPain on movement and early morphine consumption were lowest in groups receiving spinal morphine and was not improved by TAP block. The rank order of median pain scores on movement at 6 h was: S(M)T(LA) (20 mm)<S(M)T(S) (27.5 mm)<S(S)T(S) (51.5 mm)<S(S)T(LA) (52.0 mm) (P<0.05, highest vs lowest). The rank order of median morphine consumption at 6 h was: S(M)T(S) (4.0 mg)<S(M)T(LA) (5.0 mg)<S(S)T(LA) (8.0 mg)<S(S)T(S) (12.0 mg) and at 24 h was: S(M)T(LA) (5.0 mg)<S(M)T(S) (6.0 mg)<S(S)T(S) (9.5 mg)<S(S)T(LA) (15.0 mg) (P<0.05, highest vs lowest). Sedation scores and patient satisfaction did not differ between groups. Anti-emetic use and pruritus were highest in the S(M)T(LA) group.-
dc.description.abstractSpinal morphine-but not TAP block-improved analgesia after Caesarean section. The addition of TAP block with bupivacaine 2 mg kg(-1) to spinal morphine did not further improve analgesia.-
dc.language.isoenen
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pubmed/21498494en
dc.subject.meshAbdominal Muscles-
dc.subject.meshAdult-
dc.subject.meshAnalgesia, Obstetrical-
dc.subject.meshAnalgesics, Opioid-
dc.subject.meshAnesthesia, Obstetrical-
dc.subject.meshAnesthesia, Spinal-
dc.subject.meshAntiemetics-
dc.subject.meshCesarean Section-
dc.subject.meshDouble-Blind Method-
dc.subject.meshDrug Administration Schedule-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshMorphine-
dc.subject.meshNerve Block-
dc.subject.meshPain Measurement-
dc.subject.meshPain, Postoperative-
dc.subject.meshPatient Satisfaction-
dc.subject.meshPregnancy-
dc.subject.meshProspective Studies-
dc.subject.meshPruritus-
dc.titleComparison of transversus abdominis plane block vs spinal morphine for pain relief after Caesarean section.en
dc.typeArticleen
dc.contributor.departmentDepartment of Anesthesia, Rotunda Hospital, Parnell Square, Dublin 1, Ireland.en
dc.identifier.journalBritish journal of anaesthesiaen
dc.description.provinceLeinster-
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