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Created February 15, 2016, last updated over 3 years ago.
Collection: 70, Score: 1551, Trend score: 0, Read count: 1752, Articles count: 2, Created: 2016-02-15 03:03:47 UTC. Updated: 2021-03-08 09:23:32 UTC.Notes
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Collected Articles
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Randomized Controlled Trial Comparative Study
Remifentanil for labour analgesia: a double-blinded, randomised controlled trial of maternal and neonatal effects of patient-controlled analgesia versus continuous infusion.
Remifentanil patient controlled analgesia during labour is more effective and results in less remifentanil consumed than does continuous infusion.
pearl -
Review Meta Analysis
Quadratus lumborum block vs. transversus abdominis plane block for caesarean delivery: a systematic review and network meta-analysis.
Take-away message
- Analgesia post-caesarean section (CS) is of global importance, as both the most frequently performed surgical procedure, and one that is commonly associated with significant pain, impacting maternal experience.
- Fascial blocks, such as the transversus abdominis plane (TAP) and quadratus lumborum block (QLB), have been advocated for use in reducing post-CS pain. This network meta-analysis confirms the equivalent benefit of either block in improving post-operative pain in the absence of using intrathecal morphine.
- Although the QLB is advocated for its potential to reduce both somatic and visceral pain, unlike the TAP block, comparing studies investigating either block did not reveal any significant benefit of TAP over QLB.
- No analgesic benefit was found for either when intrathecal morphine is used (although TAP block may be associated with lower incidence of nausea, vomiting & sedation, in the presence of IT morphine).
- As is common to many meta-analyses, these conclusions are somewhat undermined by the moderate-to-low levels of evidence in the included studies.
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