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. 2022 Dec;11(4):1287-1298.
doi: 10.1007/s40122-022-00425-6. Epub 2022 Aug 18.

Analgesia Effect of Ultrasound-Guided Transversus Abdominis Plane Block Combined with Intravenous Analgesia After Cesarean Section: A Double-Blind Controlled Trial

Mengwen Xue #  1 , Cong Guo #  2 , Kunyu Han  1 , Ruiping Bai  1 , Rui An  1 , Xin Shen  3
Affiliations

Analgesia Effect of Ultrasound-Guided Transversus Abdominis Plane Block Combined with Intravenous Analgesia After Cesarean Section: A Double-Blind Controlled Trial

Mengwen Xue et al. Pain Ther. 2022 Dec.

Abstract

Introduction: Complete postoperative analgesia is very important for puerperae after cesarean section. The objective of this study was to explore the optimal postoperative analgesia after cesarean section.

Methods: A total of 180 full-term puerperae who underwent cesarean section in Hanzhong People's Hospital from March 2019 to March 2020 were enrolled and were randomly divided into three groups. Group A was given 0.9% normal saline, group B and C were given 0.4% ropivacaine for transversus abdominis plane block (TAPB). Postoperative patient-controlled intravenous analgesia (PCIA) pumps were 2 μg/kg sufentanil + 2.5 mg droperidol, 1.5 μg/kg and 1.3 μg/kg sufentanil, respectively. All puerperae were given different but effective analgesia programs. The primary outcome indicators were visual analog scores (VAS), the first compression time of postoperative analgesia pump and the total number of compressions in 48 h. The secondary outcome indicators were vital signs, Ramsay sedation scores, comfort scores (BCS), the frequency of analgesic rescue, postoperative side effects and satisfaction.

Results: The dynamic and static VAS scores of the puerperae in group B at T2 and T6 were significantly lower than group A and at T12, T24 and T48 were significantly lower than group C. Compared with group A, the dynamic and static VAS scores of puerperae in group C were lower at T2 and T6 and higher at T12, T24 and T48. The Ramsay score and BCS score of the puerperae in group C at T12, T24 and T48 were significantly lower than those in groups A and B.

Conclusions: PCIA with sufentanil alone or combined with TAPB can be safely and effectively used for postoperative analgesia after cesarean section. PCIA combined with TAPB had better analgesic effect and lower incidence of side effects while reducing the dose of opioids. The results of this study provide new ideas and insights for the choice of analgesia after cesarean section.

Keywords: Multi-modal analgesia; Patient-controlled intravenous analgesia; Postoperative analgesia; Transversus abdominis plane block.

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Figures

Fig. 1
Fig. 1
CONSORT diagram of patient flow
Fig. 2
Fig. 2
Comparison of the static VAS scores at different time points
Fig. 3
Fig. 3
Comparison of the dynamic VAS scores of turning 90° movement state at different time points
Fig. 4
Fig. 4
Comparison of the postoperative Ramsay score at different time points
Fig. 5
Fig. 5
Comparison of the postoperative comfort score at different time points
See this image and copyright information in PMC

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