Skip to main content

Advertisement

Log in

Transversus abdominis plane block reduces postoperative pain intensity and analgesic consumption in elective cesarean delivery under general anesthesia

  • Original Article
  • Published:
Journal of Anesthesia Aims and scope Submit manuscript

Abstract

Purpose

It is reported that following abdominal surgery, transversus abdominis plane (TAP) block can reduce postoperative pain. The primary outcome of this study was the evaluation of the efficacy of TAP block on pain intensity following cesarean delivery with Pfannenstiel incision.

Methods

Fifty pregnant women were randomized blindly to receive either a TAP block with 15 ml 0.25% bupivacaine in both sides (group T, n = 25) or no blockade (group C, n = 25) at the end of the surgery, which was performed with a Pfannenstiel incision under general anesthesia. The pain intensity in the patients was assessed by a blinded investigator at the time of discharge from recovery and at 6, 12, and 24 h postoperatively, with a visual analogue scale (VAS) for pain.

Results

The women in the TAP block group had significantly lower VAS pain scores at rest and during coughing and consumed significantly less tramadol than the women in group C [50 mg (0–150) vs. 250 mg (0–400), P = 0.001]. There was a significantly longer time to the first request for analgesic in the TAP block group [210 min (0–300) vs. 30 min (10–180) in group C, P = 0.0001].

Conclusion

Two-sided TAP block with 0.25% bupivacaine in parturients who undergo cesarean section with a Pfannenstiel incision under general anesthesia can decrease postoperative pain and analgesic consumption. The time to the first analgesic rescue was longer in the parturients who received the TAP block.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Krivak TC, Zorn KK. Venous thromboembolism in obstetrics and gynecology. Obstet Gynecol. 2007;109(3):761–77.

    Article  PubMed  Google Scholar 

  2. Bijur PE, Schechter C, Esses D, Chang AK, Gallagher EJ. Intravenous bolus of ultra-low-dose naloxone added to morphine does not enhance analgesia in emergency department patients. J Pain. 2006;7(2):75–81.

    Article  PubMed  CAS  Google Scholar 

  3. Movafegh A, Razazian M, Hajimaohamadi F, Meysamie A. Dexamethasone added to lidocaine prolongs axillary brachial plexus blockade. Anesth Analg. 2006;102(1):263–7.

    Article  PubMed  CAS  Google Scholar 

  4. Yu SC, Ngan Kee WD, Kwan AS. Addition of meperidine to bupivacaine for spinal anaesthesia for Caesarean section. Br J Anaesth. 2002;88:379–83.

    Article  PubMed  CAS  Google Scholar 

  5. Booth JV, Lindsay, Olufolabi AJ, EL-Moalem HE, Penning DH, Reynolds JD. Subarachnoid meperidine (Pethidine) causes significant nausea and vomiting during labor. Anesthesiology. 2000;93:418–21.

    Article  PubMed  CAS  Google Scholar 

  6. Mc Donnell JG, O’Donnell BD, Curley G, Heffernan A, Pourer C, Laffey JG. The analgesic efficacy of transversus abdominis plane block after abdominal surgery: a prospective randomized controlled trial. Anesth Analg. 2007;104:193–7.

    Article  Google Scholar 

  7. Rafi AN. Abdominal field block: a new approach via the lumbar triangle. Anesthesia. 2001;56:1024–6.

    Article  CAS  Google Scholar 

  8. O’Donnelle BD. The transversus abdominis plane block in open retropubic prostatectomy. Letter to the editor. Reg Anesth Pain Med. 2006;31(1):91.

    Google Scholar 

  9. Wittels B, Scott DT, Sinatra RS. Exogenous opioids in human breast milk and acute neonatal neurobehavior: a preliminary study. Anesthesiology. 1990;73:864–9.

    Article  PubMed  CAS  Google Scholar 

  10. Carney JJ, MC Donnell JG, Ochana A, Bhinder R, Laffey JG. The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy. Anesth Analg. 2008;107:2056–60.

    Article  PubMed  CAS  Google Scholar 

  11. MC Donnell JG, Curley G, Carney J, Benton A, Costello J, Maharaj CH. The analgesic efficacy of transversus abdominis plane block after cesarean delivery: a randomized controlled trial. Anesth Analg. 2008;106:186–91.

    Article  CAS  Google Scholar 

  12. Mukhtar K, Singh S. Transversus abdominis plane block for laparoscopic surgery. Br J Anaesth. 2009;109:143–4.

    Article  Google Scholar 

  13. Hebbard P. Audit of “rescue” analgesic using TAP block. Anaesth Intensive Care. 2007;35:617–8.

    PubMed  CAS  Google Scholar 

  14. Park T, Mickelson J, Yerkes E, Suresh S. Transversus abdominis plane block: a new approach to the management of secondary hyperalgesia following major abdominal surgery. Paediatr Anaesth. 2009;19:54–6.

    Google Scholar 

  15. Barrington MJ, Ivanusic JJ, Rosen WM, Hebbard P. Spread of injectate after ultrasound-guided sub costal transversus abdominis plane block: a cadaveric study. Anaesthesia. 2009;64:745–50.

    Article  PubMed  CAS  Google Scholar 

  16. Puddy E, Edwards B, Wrenchand I, Roberts F. Does the transversus abdominis plane (TAP) block improve analgesia following subarachnoid anesthesia with intrathecal diamorphine? A randomized double blinded control trial. Anaesthesia. 2010;65:95.

    Article  Google Scholar 

  17. Costello JF, Moore AR, Wieczorek PM, Macarthur AJ, Balki M, Carvalho JC. 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):586–9.

    Article  PubMed  Google Scholar 

  18. Belavy D, Cowlishaw PJ, Howes M, Phillips F. Ultrasound-guided transversus abdominis plane block for analgesia after Caesarean delivery. Br J Anaesth. 2009;103(5):726–30.

    Article  PubMed  CAS  Google Scholar 

  19. Griffiths JD, Barron FA, Grant S, Bjorksten AR, Hebbard P, Royse CF. Plasma ropivacaine concentrations after ultrasound-guided transversus abdominis plane block. Br J Anaesth. 2010;105(6):853–6.

    Article  PubMed  CAS  Google Scholar 

  20. Farooq M, Carey MA. A case of liver trauma with a blunt regional anesthesia needle while performing transversus abdominis plane block. Reg Anesth Pain Med. 2008;33(.3):274–5.

    PubMed  Google Scholar 

  21. Scharine JD. Bilateral transversus abdominis plane nerve blocks for analgesia following cesarean delivery: report of 2 cases. AANA J. 2009;77(2):98–102.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ali Movafegh.

About this article

Cite this article

Eslamian, L., Jalili, Z., Jamal, A. et al. Transversus abdominis plane block reduces postoperative pain intensity and analgesic consumption in elective cesarean delivery under general anesthesia. J Anesth 26, 334–338 (2012). https://doi.org/10.1007/s00540-012-1336-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00540-012-1336-3

Keywords

Navigation