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Created May 21, 2015, last updated over 2 years ago.
Collection: 16, Score: 2599, Trend score: 0, Read count: 3002, Articles count: 11, Created: 2015-05-21 03:54:17 UTC. Updated: 2022-07-08 11:35:54 UTC.Notes
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Collected Articles
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Review Meta Analysis
Duration of analgesic effectiveness after the posterior and lateral transversus abdominis plane block techniques for transverse lower abdominal incisions: a meta-analysis.
Posterior transversus abdominis plane block continues to reduce pain scores and opioid consumption at up to 48 hours, though with lesser magnitude.
pearl -
Randomized Controlled Trial Comparative Study
Comparison of analgesic efficacy of four-quadrant transversus abdominis plane (TAP) block and continuous posterior TAP analgesia with epidural analgesia in patients undergoing laparoscopic colorectal surgery: an open-label, randomised, non-inferiority trial.
Four-quadrant transversus abdominis plane block with bilateral posterior TAP catheters for 48 hours provides analgesia equivalent to epidural analgesia in patients having laparoscopic colorectal surgery.
summary -
Randomized Controlled Trial
Transversus abdominis plane block does not improve early or late pain outcomes after Cesarean delivery: a randomized controlled trial.
Transversus abdominis plane block does not improve post-caesarean analgesia in women receiving regional anaesthesia with intrathecal morphine.
pearl -
Review Meta Analysis Comparative Study
Transversus abdominis plane block for analgesia after Cesarean delivery: a systematic review and meta-analysis.
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Randomized Controlled Trial
A randomised trial of the analgesic efficacy of ultrasound-guided transversus abdominis plane block after caesarean delivery under general anaesthesia.
Ultrasound guided TAP block significantly reduces morphine consumption and improves satisfaction following general anaesthesia caesarean section.
pearl -
Int J Obstet Anesth · Jul 2013
Randomized Controlled TrialEfficacy of ultrasound-guided transversus abdominis plane blocks for post-cesarean delivery analgesia: a double-blind, dose-comparison, placebo-controlled randomized trial.
TAP blocks may offer some small analgesic benefit after caesarean section at 6h and 12h, but not 24h, in patients also receiving intrathecal morphine.
pearl -
Int J Obstet Anesth · Apr 2012
Randomized Controlled Trial Comparative StudyA randomized controlled trial comparing intrathecal morphine with transversus abdominis plane block for post-cesarean delivery analgesia.
Intrathecal morphine is an effective analgesic post-cesarean delivery; however, it may be contraindicated or unsuitable in some patients. We compared the efficacy and side effects of intrathecal morphine with an ultrasound-guided transversus abdominis plane (TAP) block in a randomized, controlled, double-blinded trial. The primary outcome was the morphine equivalents dose used in the first 24 h post-surgery. Secondary outcomes were pain scores and side effects, including pruritus, sedation, nausea and vomiting. ⋯ In this trial, the TAP block was associated with greater supplemental morphine requirements and higher pain scores than intrathecal morphine but fewer opioid-related side effects. The TAP block may be a reasonable alternative when intrathecal morphine is contraindicated or not appropriate.
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Randomized Controlled Trial
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. ⋯ 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.
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Randomized Controlled Trial Comparative Study
The analgesic effects of intrathecal morphine in comparison with ultrasound-guided transversus abdominis plane block after caesarean section: a randomised controlled trial at a Ugandan regional referral hospital.
What did they do?
The researchers randomised 130 women to 10 mg intrathecal hyperbaric bupivacaine plus an ultrasound-guided TAP block, or to 10mg intrathecal hyperbaric bupivacaine with 100 mcg morphine, plus a sham TAP block.
And they found
There was no difference between either group for satisfaction, analgesia or adverse effects. They concluded that in the context of intrathecal morphine availability, there is no benefit from TAP block, although TAP block can produce comparable analgesia if IT morphine is not used.
What’s particularly interesting...
Unlike the majority of obstetric anaesthesia research, this study comes from the same environment that also manages the bulk of global deliveries: low and medium income countries.
It is also an important reminder that not only are techniques used in wealthier countries applicable and translatable to lower-resource settings, but so is high quality research – and as with all research, context is everything.
summary -
Review Meta Analysis
Efficacy of regional blocks or local anaesthetic infiltration for analgesia after caesarean delivery: a network meta-analysis of randomised controlled trials.
Caesarean delivery is common and can cause severe postoperative pain but injection of local anaesthetic at various sites for regional blocks or local anaesthetic infiltration may reduce this. We aimed to compare and rank these sites. We searched PubMed, Google Scholar, EMBASE and CENTRAL to June 2021 for randomised controlled trials and performed a random-effects Bayesian model network meta-analysis. ⋯ Ordered efficacies for injection sites were different for other relevant outcomes, including pain (to 4-6 h and to 24 h) and time to rescue analgesia: there was no single preferred route of injection. The ordered mean (95% credible interval) reduction in dynamic pain scores (0-10 scale) at 24 h compared with placebo were as follows: wound infusion 1.2 (0.2-2.1); erector spinae 1.3 (-0.5 to 3.1); quadratus lumborum 1.0 (0.1-1.8); ilio-inguinal-iliohypogastric 0.6 (-0.5 to 1.8); transverse abdominis 0.6 (-0.1 to 1.2); wound infiltration 0.5 (-0.3 to 1.3); transversalis fascia -0.8 (-3.4 to 1.9); ilio-inguinal -0.9 (-3.6 to 1.7); and no intervention -0.8 (-1.8 to 0.2). We categorised our confidence in effect sizes as low or very low.
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