Clinical study of ultrasound-guided transversus abdominis plane block for analgesia after cesarean section

Medicine (Baltimore). 2019 Oct;98(41):e17542. doi: 10.1097/MD.0000000000017542.

Abstract

Background: Patient-controlled intravenous analgesia (PCIA) and patient-controlled epidural analgesia are 2 common methods of maintaining analgesia after cesarean section. In recent years, transversus abdominis plane block (TAPB) has been gradually applied clinically to reduce opioid analgesics and has achieved good results. Therefore, we performed this study to compare the efficacy and side effects of TAPB and PCIA in analgesia after cesarean section.

Methods: One hundred patients who underwent cesarean section were randomly classified into 2 groups. Following surgery, one group underwent ultrasound-guided TAPB and the other group underwent PCIA. Pain intensity according to the visual analog scale (VAS; 0 for no pain and 10 for severe intolerable pain) was assessed at 2, 4, 6, 8, 12, and 24-hour postsurgery in both groups. The postoperative complication rate and patient satisfaction were also measured.

Results: No significant differences were found in the VAS scores between the groups (P > .05). However, the incidence of postoperative complications in the TAPB group was significantly lower than that in the PCIA group (P < .05). Furthermore, patient satisfaction in the TAPB group was significantly higher than that in the PCIA group (P < .05).

Conclusion: This study demonstrated that ultrasound-guided TAPB can achieve the same analgesic effect as PCIA after cesarean section but with even higher patient satisfaction.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Abdominal Muscles / diagnostic imaging
  • Abdominal Muscles / drug effects
  • Abdominal Muscles / innervation*
  • Adult
  • Analgesia, Patient-Controlled / methods*
  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use
  • Cesarean Section / adverse effects*
  • Cesarean Section / methods
  • Female
  • Humans
  • Incidence
  • Nerve Block / adverse effects
  • Nerve Block / methods*
  • Patient Satisfaction / statistics & numerical data
  • Postoperative Complications / epidemiology
  • Pregnancy
  • Quality of Life
  • Ultrasonography, Interventional / methods*
  • Visual Analog Scale

Substances

  • Analgesics, Opioid