A randomized trial comparing surgeon-administered intraoperative transversus abdominis plane block with anesthesiologist-administered transcutaneous block

D. M. Narasimhulu, L. Scharfman, H. Minkoff, B. George, P. Homel, K. Tyagaraj

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Background: Injection of local anesthetic into the transversus abdominis plane (TAP block) decreases systemic morphine requirements after abdominal surgery. We compared intraoperative surgeon-administered TAP block (surgical TAP) to anesthesiologist-administered transcutaneous ultrasound-guided TAP block (conventional TAP) for post-cesarean analgesia. We hypothesized that surgical TAP blocks would take less time to perform than conventional TAP blocks. Methods: We performed a randomized trial, recruiting 41 women undergoing cesarean delivery under neuraxial anesthesia, assigning them to either surgical TAP block (n=20) or conventional TAP block (n=21). Time taken to perform the block was the primary outcome, while postoperative pain scores and 24-hour opioid requirements were secondary outcomes. Student's t-test was used to compare block time and Kruskal-Wallis test opioid consumption and pain-scores. Results: Time taken to perform the block (2.4 vs 12.1 min, P <0.001), and time spent in the operating room after delivery (55.3 vs 77.9 min, P <0.001) were significantly less for surgical TAP. The 24 h morphine consumption (P=0.17) and postoperative pain scores at 4, 8, 24 and 48 h were not significantly different between the groups. Conclusion: Surgical TAP blocks are feasible and less time consuming than conventional TAP blocks, while providing comparable analgesia after cesarean delivery.

Original languageEnglish (US)
JournalInternational Journal of Obstetric Anesthesia
DOIs
StateAccepted/In press - Jan 1 2018

Keywords

  • Analgesia
  • Postoperative
  • Transversus abdominis plane block

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Anesthesiology and Pain Medicine

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