open access

Vol 89, No 8 (2018)
Research paper
Published online: 2018-08-31
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The analgesic efficiency of transversus abdominis plane (TAP) block after caesarean delivery

Anna Kupiec1, Jacek Zwierzchowski1, Joanna Kowal-Janicka1, Waldemar Goździk1, Tomasz Fuchs2, Michał Pomorski2, Mariusz Zimmer2, Andrzej Kübler1
DOI: 10.5603/GP.a2018.0072
·
Pubmed: 30215460
·
Ginekol Pol 2018;89(8):421-424.
Affiliations
  1. Katedra i Klinika Anestezjologii i Intensywnej Terapii, ul. Borowska 213, 50-556 Wrocław, Poland
  2. II Katedra i Klinika Ginekologii i Położnictwa, ul. Borowska 213, 50-556 Wrocław, Poland

open access

Vol 89, No 8 (2018)
ORIGINAL PAPERS Gynecology
Published online: 2018-08-31

Abstract

Objectives: The ultrasound-guided transversus abdominis plane (TAP) block is a supporting method of pain relief after different types of surgical and gynecological procedures. The aim of the present study was to evaluate the analgesic effects of the TAP-block in patients undergoing caesarean section.

Material and methods: 88 women undergoing elective caesarean section under spinal anaesthesia were prospectively randomized into two groups. In the first group, an ultrasound-guided bilateral TAP block was performed using 40 mL 0.25% bupivacaine, while the second group was treated without a regional nerve block. Both groups received a standard analgesia protocol with intravenous paracetamol administered every 6 hours and intravenous tramadol on-demand, delivered using the Patient Controlled Analgesia (PCA) method. Pain intensity was assessed according to the visual analogue scale (VAS) directly after the TAP block and at 3, 6 and 12 hours postoperatively. Any patient complaints and side-effects during the postoperative period were recorded.

Results: The TAP block resulted in a significant reduction of pain intensity using the visual analogue scale after 3, 6 and 12 hours (p < 0.05) and a significant decrease in tramadol administration (p < 0.05) during the first 12 hours postoperatively. No significant differences in the heart rate and blood pressure were noted between groups (p > 0.05). There were no complications related to the TAP block.

Conclusions: The TAP block is a safe and effective adjunctive method of pain relief after caesarean delivery.

Abstract

Objectives: The ultrasound-guided transversus abdominis plane (TAP) block is a supporting method of pain relief after different types of surgical and gynecological procedures. The aim of the present study was to evaluate the analgesic effects of the TAP-block in patients undergoing caesarean section.

Material and methods: 88 women undergoing elective caesarean section under spinal anaesthesia were prospectively randomized into two groups. In the first group, an ultrasound-guided bilateral TAP block was performed using 40 mL 0.25% bupivacaine, while the second group was treated without a regional nerve block. Both groups received a standard analgesia protocol with intravenous paracetamol administered every 6 hours and intravenous tramadol on-demand, delivered using the Patient Controlled Analgesia (PCA) method. Pain intensity was assessed according to the visual analogue scale (VAS) directly after the TAP block and at 3, 6 and 12 hours postoperatively. Any patient complaints and side-effects during the postoperative period were recorded.

Results: The TAP block resulted in a significant reduction of pain intensity using the visual analogue scale after 3, 6 and 12 hours (p < 0.05) and a significant decrease in tramadol administration (p < 0.05) during the first 12 hours postoperatively. No significant differences in the heart rate and blood pressure were noted between groups (p > 0.05). There were no complications related to the TAP block.

Conclusions: The TAP block is a safe and effective adjunctive method of pain relief after caesarean delivery.

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Keywords

TAP block, caesarean section, postoperative pain

About this article
Title

The analgesic efficiency of transversus abdominis plane (TAP) block after caesarean delivery

Journal

Ginekologia Polska

Issue

Vol 89, No 8 (2018)

Article type

Research paper

Pages

421-424

Published online

2018-08-31

DOI

10.5603/GP.a2018.0072

Pubmed

30215460

Bibliographic record

Ginekol Pol 2018;89(8):421-424.

Keywords

TAP block
caesarean section
postoperative pain

Authors

Anna Kupiec
Jacek Zwierzchowski
Joanna Kowal-Janicka
Waldemar Goździk
Tomasz Fuchs
Michał Pomorski
Mariusz Zimmer
Andrzej Kübler

References (13)
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  3. Brogi E, Kazan R, Cyr S, et al. Transversus abdominal plane block for postoperative analgesia: a systematic review and meta-analysis of randomized-controlled trials. Can J Anaesth. 2016; 63(10): 1184–1196.
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  7. Costello JF, Moore AR, Wieczorek PM, et al. The transversus abdominis plane block, when used as part of a multimodal regimen inclusive of intrathecal morphine, does not improve analgesia after cesarean delivery. Reg Anesth Pain Med. 2009; 34(6): 586–589.
  8. Abdallah FW, Halpern SH, Margarido CB. Transversus abdominis plane block for postoperative analgesia after Caesarean delivery performed under spinal anaesthesia? A systematic review and meta-analysis. Br J Anaesth. 2012; 109(5): 679–687.
  9. Carvalho FA, Tenório SB. Comparative study between doses of intrathecal morphine for analgesia after caesarean. Braz J Anesthesiol. 2013; 63(6): 492–499.
  10. Weiss E, Jolly C, Dumoulin JL, et al. Convulsions in 2 patients after bilateral ultrasound-guided transversus abdominis plane blocks for cesarean analgesia. Reg Anesth Pain Med. 2014; 39(3): 248–251.
  11. Griffiths JD, Le NV, Grant S, et al. Symptomatic local anaesthetic toxicity and plasma ropivacaine concentrations after transversus abdominis plane block for Caesarean section. Br J Anaesth. 2013; 110(6): 996–1000.
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