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Regional Anesthesia Abdominal Blocks and Local Infiltration After Cesarean Delivery: Review of Current Evidence

  • Acute Pain Medicine (R Urman, Section Editor)
  • Published:
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Abstract

Purpose of Review

In this review, we discuss surgical infiltration and various abdominal wall blocks, including transversus abdominis plane (TAP) block and quadratus lumborum blocks, and review the literature on the evidence behind these approaches and analgesia for cesarean delivery (CD).

Recent Findings

Adequate pain management in the parturient following CD is important to facilitate early ambulation and neonatal care while also improving patient satisfaction and decreasing hospital length of stay. Neuraxial opioids have been a mainstay for postoperative analgesia; however, this option may not be available for patients undergoing emergency CD and have contraindications to neuraxial approaches, refusing an epidural or spinal, or with technical difficulties for neuraxial placement. In such cases, alternative options include a fascial plane block or surgical wound infiltration. The use of regional blocks or surgical wound infiltration is especially recommended in the parturient who does not receive neuraxial opioids for CD.

Summary

Adequate postoperative analgesia following CD is an important component of the overall care of the parturient as it helps facilitate early mobilization and improve patient satisfaction. In conclusion, the use of abdominal fascial plane blocks or surgical wound infiltration is recommended in the parturient who does not receive neuraxial opioids for CD.

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Authors and Affiliations

  1. Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA

    Rodney A. Gabriel & Brian P. Curran

  2. Division of Biomedical Informatics, University of California San Diego, La Jolla, CA, USA

    Rodney A. Gabriel

  3. Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles, Los Angeles, CA, USA

    Brittany N. Burton

  4. Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA

    Richard D. Urman

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  1. Rodney A. Gabriel
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Correspondence to Rodney A. Gabriel.

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Richard D. Urman: Merck, Medtronic, Acacia, AcelRx, Takeda, Heron, NIH, AHRQ, and NSF. The other authors declare no competing interests.

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Gabriel, R.A., Burton, B.N., Curran, B.P. et al. Regional Anesthesia Abdominal Blocks and Local Infiltration After Cesarean Delivery: Review of Current Evidence. Curr Pain Headache Rep 25, 28 (2021). https://doi.org/10.1007/s11916-021-00945-4

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