Skip Navigation


BJA Advance Access originally published online on August 22, 2009
British Journal of Anaesthesia 2009 103(5):726-730; doi:10.1093/bja/aep235
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
103/5/726    most recent
aep235v1
Right arrow E-Letters: Submit a response to the article
Right arrow E-letters: View responses
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (1)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Belavy, D.
Right arrow Articles by Phillips, F.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Belavy, D.
Right arrow Articles by Phillips, F.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?


© The Author [2009]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournal.org

Ultrasound-guided transversus abdominis plane block for analgesia after Caesarean delivery

D. Belavy1,2,*, P. J. Cowlishaw1, M. Howes1 and F. Phillips1

1 Department of Anaesthesia, Mater Misericordiae Health Services, Raymond Terrace, South Brisbane, Qld, Australia
2 Present address: Royal Brisbane and Women's Hospital, Herston, Qld, Australia

* Corresponding author. E-mail: david{at}belavy.com

Background: The landmark-guided transversus abdominis plane (TAP) block is an effective method of providing postoperative analgesia in patients undergoing lower abdominal surgery. We evaluated the analgesic efficacy of the ultrasound (US)-guided TAP block in patients undergoing Caesarean delivery.

Methods: A randomized, double-blind, placebo-controlled trial was performed at a tertiary maternity hospital. Fifty women undergoing Caesarean delivery received bilateral US-guided TAP blocks with either ropivacaine 0.5% or saline. All participants received a spinal anaesthetic with bupivacaine and fentanyl, followed by postoperative acetaminophen, non-steroidal anti-inflammatory drugs, and patient-controlled i.v. morphine without long-acting intrathecal opioids. Each patient was assessed 24 h after delivery for morphine usage, average pain score, nausea, vomiting, pruritus, drowsiness, and satisfaction with pain relief.

Results: Forty-seven participants completed the trial, 23 in the active group and 24 in the placebo group. Total morphine use in 24 h was reduced in the active group (median 18.0 mg) compared with the placebo group (median 31.5 mg, P<0.05). The active group reported improved satisfaction with their pain relief measured by visual analogue scale compared with the placebo group (median 96 vs 77 mm, P=0.008). Fewer patients required antiemetics in the active group (P=0.03). There were no local complications attributable to the TAP block, but one participant had an anaphylactoid reaction after ropivacaine injection.

Conclusions: The US-guided TAP block reduces morphine requirements after Caesarean delivery when used as a component of a multimodal analgesic regimen.

Registered with the Australia New Zealand Clinical Trials Registry ACTRN12608000540314. URL: http://www.anzctr.org.au/trial_view.aspx?ID=83176.

Keywords: anaesthesia, obstetric; anaesthetic techniques, regional


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Br J AnaesthHome page
G. Walker
Transversus abdominis plane block: a note of caution!
Br. J. Anaesth., February 1, 2010; 104(2): 265 - 265.
[Full Text] [PDF]

E-letters:

Read all E-letters

Re: TAP block, potential accidental femoral palsy
Graham J Walker
British Journal of Anaesthesia, 25 Nov 2009 [Full text]
TAP Block following LUSCS: Where do we go from here?
Lee M Riddell, et al.
British Journal of Anaesthesia, 15 Dec 2009 [Full text]

Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.