Subarachnoid block and ultrasound-guided transversalis fascia plane block for caesarean section: A randomised, double-blind, placebo-controlled trial.
Eur J Anaesthesiol
; 37(9): 765-772, 2020 Sep.
Article
em En
| MEDLINE
| ID: mdl-32412986
ABSTRACT
BACKGROUND:
After caesarean section, maternal postoperative comfort is critical to allow the new mother to care for her baby. Insufficient pain relief during the postoperative period may delay maternal/infant bonding and, in addition, such pain has been linked to subsequent depression and chronic pain. Caesarean section is commonly performed with a Pfannenstiel incision, and a transversalis fascia plane (TFP) block provides postoperative analgesia in the T12 and L1 dermatomes.OBJECTIVE:
The aim of this study was to investigate the effect of the TFP block on postoperative opioid consumption and pain scores in patients undergoing caesarean section under spinal anaesthesia.DESIGN:
A randomised controlled, double-blind study. SETTINGS Single-centre, academic hospital.PARTICIPANTS:
Sixty patients undergoing caesarean section.INTERVENTIONS:
The TFP group (nâ=â30) received an ultrasound-guided bilateral TFP block with 20âml of 0.25% bupivacaine. The control group (nâ=â30) received 20âml of saline bilaterally. Postoperative analgesia was given every 6âh with intravenous paracetamol 1 g and patient-controlled analgesia (PCA) with morphine. MAIN OUTCOMEMEASURES:
Postoperative visual analogue pain scores, morphine consumption, rescue analgesia and opioid-related side effects were evaluated.RESULTS:
In the TFP group, the visual analogue pain scores were significantly lower at rest for 2âh after the operation (Pâ=â0.011) and during active movement at 2, 4 and 8âh postoperatively (Pâ=â0.014, <0.001 and 0.032, respectively). Morphine consumption in the first 24âh after surgery was significantly higher in the control group compared with the TFP group (38.5â±â11.63 and 19.5â±â8.33âmg, respectively; Pâ<â0.001). The incidence of postoperative nausea and constipation were statistically higher in the control group than in the TFP group (Pâ<â0.05). Patient satisfaction was significantly higher in the TFP group (Pâ=â0.027).CONCLUSION:
A postoperative TFP block can reduce opioid consumption and relieve acute pain after a caesarean section under spinal anaesthesia. TRIAL REGISTRATION ClinicalTrials.gov, NCT04172727.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Raquianestesia
/
Bloqueio Nervoso
Limite:
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
Eur J Anaesthesiol
Assunto da revista:
ANESTESIOLOGIA
Ano de publicação:
2020
Tipo de documento:
Article