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    The analgesic efficacy of transversus abdominis plane block after cesarean delivery: a randomized controlled trial.

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    Authors
    McDonnell, John G
    Curley, Gerard
    Carney, John
    Benton, Aoife
    Costello, Joseph
    Maharaj, Chrisen H
    Laffey, John G
    Affiliation
    Department of Anaesthesia, Clinical Sciences Institute, Centre for Pain Research, National University of Ireland, Galway, Ireland.
    Issue Date
    2008-01
    MeSH
    Abdominal Wall
    Acetaminophen
    Adult
    Amides
    Analgesia, Patient-Controlled
    Analgesics, Non-Narcotic
    Analgesics, Opioid
    Anesthesia, Spinal
    Anesthetics, Local
    Anti-Inflammatory Agents, Non-Steroidal
    Cesarean Section
    Diclofenac
    Double-Blind Method
    Drug Therapy, Combination
    Female
    Humans
    Morphine
    Nerve Block
    Pain Measurement
    Pain, Postoperative
    Pregnancy
    Surgical Procedures, Elective
    Time Factors
    Treatment Outcome
    Wakefulness
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    Citation
    The analgesic efficacy of transversus abdominis plane block after cesarean delivery: a randomized controlled trial. 2008, 106 (1):186-91, table of contents Anesth. Analg.
    Journal
    Anesthesia and analgesia
    URI
    http://hdl.handle.net/10147/127912
    DOI
    10.1213/01.ane.0000290294.64090.f3
    PubMed ID
    18165577
    Abstract
    The transversus abdominis plane (TAP) block is an effective method of providing postoperative analgesia in patients undergoing midline abdominal wall incisions. We evaluated its analgesic efficacy over the first 48 postoperative hours after cesarean delivery performed through a Pfannensteil incision, in a randomized controlled, double-blind, clinical trial.
    Fifty women undergoing elective cesarean delivery were randomized to undergo TAP block with ropivacaine (n = 25) versus placebo (n = 25), in addition to standard postoperative analgesia comprising patient-controlled IV morphine analgesia and regular diclofenac and acetaminophen. All patients received a standard spinal anesthetic, and at the end of surgery, a bilateral TAP block was performed using 1.5 mg/kg ropivacaine (to a maximal dose of 150 mg) or saline on each side. Each patient was assessed postoperatively by a blinded investigator: in the postanesthesia care unit and at 2, 4, 6, 12, 24, 36, and 48 h postoperatively.
    The TAP block with ropivacaine compared with placebo reduced postoperative visual analog scale pain scores. Mean (+/- sd) total morphine requirements in the first 48 postoperative hours were also reduced (66 +/- 26 vs 18 +/- 14 mg, P < 0.001), as was the 12-h interval morphine consumption up to 36 h postoperatively. The incidence of sedation was reduced in patients undergoing TAP blockade. There were no complications attributable to the TAP block.
    The TAP block, as a component of a multimodal analgesic regimen, provided superior analgesia when compared with placebo block up to 48 postoperative hours after elective cesarean delivery.
    Item Type
    Article
    Language
    en
    ISSN
    1526-7598
    ae974a485f413a2113503eed53cd6c53
    10.1213/01.ane.0000290294.64090.f3
    Scopus Count
    Collections
    Galway University Hospitals

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