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Effects of Ultrasonography-Guided Transversus Abdominis Plane Block on Postoperative Analgesia, Gastrointestinal Motility, and Mobilization in Patients Delivering Cesarean Delivery Under Spinal Anesthesia: A Retrospective Study

Year 2023, Volume: 25 Issue: 2, 167 - 172, 30.08.2023
https://doi.org/10.18678/dtfd.1293886

Abstract

Aim: The aim of this study was to investigate the effect of ultrasonography (USG)-guided transversus abdominis plane (TAP) block on postoperative analgesia, gastrointestinal motility, and mobilization time in patients who had a cesarean section under spinal anesthesia.
Material and Methods: The follow-up forms of the total 81 patients who had elective cesarean delivery under spinal anesthesia between March 2022 and June 2022 were reviewed retrospectively. The patients were divided into two groups, 41 patients as the TAP block applied group (group T) and 40 patients as the control group (group C). Demographic data of patients, visual analog scale (VAS) values at postoperative 2nd-, 4th-, 6th-, 12th-, and 24th-hour, tramadol requirements, non-steroidal anti-inflammatory drug (NSAID) and tramadol consumption, postoperative nausea-vomiting (PONV) status, initial gas release times and mobilization times were analyzed.
Results: The VAS scores of the patients in group T at the postoperative period 2nd-, 4th-, and 6th-hour were significantly lower than those of group C (p<0.001). However, the rate of PONV (p=0.006), tramadol requirement (p=0.002), amount of tramadol (p=0.003) and NSAID consumed (p<0.001), and mobilization time (p=0.005) were significantly lower in patients in group T. The time until the passage of flatus was short in Group T, although it was not significant (p=0.072).
Conclusion: The USG-guided TAP block significantly contributes to multimodal analgesia after cesarean delivery and may contribute to the early mobilization of patients and the return of gastrointestinal functions.

References

  • Sinatra R. Causes and consequences of inadequate management of acute pain. Pain Med. 2010;11(12):1859-71.
  • McDonnell NJ, Keating ML, Muchatuta NA, Pavy TJ, Paech MJ. Analgesia after caesarean delivery. Anaesth Intensive Care. 2009;37(4):539‑51.
  • Mankikar MG, Sardesai SP, Ghodki PS. Ultrasound guided transversus abdominis plane block for post-operative analgesia in patients undergoing caesarean section. Indian J Anaesth. 2016;60(4):253-7.
  • Tan TT, Teoh WH, Woo DC, Ocampo CE, Shah MK, Sia AT. A randomised trial of the analgesic efficacy of ultrasoundguided transversus abdominis plane block after caesarean delivery under general anesthesia. Eur J Anaesthesiol. 2012;29(2):88-94.
  • Çetin Arslan H, Arslan K. Eras management in obstetric and gynecological interventions. In: Demir C, editor. Obstetrics and Gynecology II. Ankara: Akademisyen Publishing House; 2022. p.57-62.
  • Oksar M, Koyuncu O, Turhanoglu S, Temiz M, Oran MC. Transversus abdominis plane block as a component of multimodal analgesia for laparoscopic cholecystectomy. J Clin Anesth. 2016:34:72-8.
  • Edney JC, Lam H, Raval MV, Heiss KF, Austin TM. Implementation of an enhanced recovery program in pediatric laparoscopic colorectal patients does not worsen analgesia despite reduced perioperative opioids: a retrospective, matched, non-inferiority study. Reg Anesth Pain Med. 2019;44(1):123-9.
  • Sahin ÖF, Aksoy Y, Kaydu A, Gökçek E. The effect of bilateral TAP block administration on analgesic consumption in cesarean operations under spinal anesthesia. Ortadoğu Tıp Derg. 2018;10(2):149-53. Turkish.
  • Aydogmus M, Sinikoglu S, Naki M, Ocak N, Sanlı N, Alagol A. Comparison of analgesic efficiency between wound site infiltration and ultra-sound-guided transversus abdominis plane block after cesarean delivery under spinal anaesthesia. Hippokratia. 2014;18(1):28-31.
  • Hebbard P. Subcostal transversus abdominis plane block under ultrasound guidance. Anesth Analg. 2008;106(2):674-5.
  • Kalisch BJ, Lee S, Dabney BW. Outcomes of inpatient mobilization: a literature review. J Clin Nurs. 2014;23(11-12):1486-501.
  • Pereira Gomes Morais E, Riera R, Porfírio GJ, Macedo CR, Sarmento Vasconcelos V, Souza Pedrosa A, et al. Chewing gum for enhancing early recovery of bowel function after caesarean section. Cochrane Database Syst Rev. 2016;10(10):CD011562.
  • Small C, Laycock H. Acute postoperative pain management. Br J Surg. 2020;107(2):e70-80.
  • Beverly A, Kaye AD, Ljungqvist O, Urman RD. Essential elements of multimodal analgesia in enhanced recovery after surgery (ERAS) guidelines. Anesthesiol Clin. 2017;35(2):e115-43.
  • Baaj JM, Alsatli RA, Majaj HA, Babay ZA, Thallaj AK. Efficacy of ultrasound-guided transversus abdominis plane (TAP) block for post-cesarean section delivery analgesia. Middle East J Anaesthesiol. 2010;20(6):821-6.
  • Cansiz KH, Yedekçi AE, Sen H, Ozkan S, Dagli G. The effect of ultrasound guided transversus abdominis plane block for cesarean delivery on postoperative analgesic consumption. Gulhane Med J. 2015;57(2):121-4.
  • Belavy D, Cowlishaw PJ, Howes M, Phillips F. Ultrasound guided transversus abdominis plane block for analgesia after caesarean delivery. Br J Anaesth. 2009;103(5):726-30.
  • El-Dawlatly AA, Turkistani A, Kettner SC, Machata AM, Delvi MB, Thallaj A, et al. Ultrasound-guided transversus abdominis plane block: Description of a new technique and comparison with conventional systemic analgesia during laparoscopic cholecystectomy. Br J Anaesth. 2009;102(6):763-7.
  • Wu CL, King AB, Geiger TM, Grant MC, Grocott MPW, Gupta R, et al. American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on perioperative opioid minimization in opioid-Naïve patients. Anesth Analg. 2019;129(2):567-7.
  • Allen BFS, Jablonski PM, McEvoy MD, Ehrenfeld JM, Shi H, King AB, et al. Implementation of an Enhanced Recovery Protocol (ERP) is associated with an increase in the perioperative use of non-opioid multimodal analgesia for non-ERP patients. J Clin Anesth. 2020;62:109694.
  • Colvin LA, Bull F, Hales TG. Perioperative opioid analgesia-when is enough too much? A review of opioid-induced tolerance and hyperalgesia. Lancet. 2019;393(10180):1558-68.
  • Meylan N, Elia N, Lysakowski C, Tramèr MR. Benefit and risk of intrathecal morphine without local anaesthetic in patients undergoing major surgery: meta-analysis of randomized trials. Br J Anaesth. 2009;102(2):156-67.
  • Zhang L, Jia Z, Gao T, Wang Y, Zhao Y, Li J, et al. A randomized controlled trial evaluating the effects of transversus abdominis plane block with compound lidocaine hydrochloride injection on postoperative pain and opioid consumption and gastrointestinal motility in patients undergoing gynecological laparotomy. Front Mol Neurosci. 2023;16:967917.
  • Srivastava U, Verma S, Singh TK, Gupta A, Saxsena A, Jagar KD, et al. Efficacy of trans abdominis plane block for post cesarean delivery analgesia: A double-blind, randomized trial. Saudi J Anaesth. 2015;9(3):298-302.
  • Farooq M, Carey M. A case of liver trauma with a blunt regional anesthesia needle while performing transversus abdominis plane block. Reg Anesth Pain Med. 2008;33(3):274-5.
  • Lancaster P, Chadwick M. Liver trauma secondary to ultrasound-guided transversus abdominis plane block. Br J Anaesth. 2010;104(4):509-10.
  • Mukhtar K, Singh S. Transversus abdominis plane block for laparoscopic surgery. Br J Anaesth. 2009;102(1):143-4.
  • El-Boghdadly K, Pawa A, Chin KJ. Local anesthetic systemic toxicity: current perspectives. Local Reg Anesth. 2018;11:35-44.

Spinal Anestezi Altında Sezaryen Doğum Gerçekleştiren Hastalarda Ultrasonografi Kılavuzluğunda Uygulanan Transversus Abdominis Plan Bloğun Postoperatif Analjezi, Gastrointestinal Motilite ve Mobilizasyon Zamanına Etkisi: Retrospektif Çalışma

Year 2023, Volume: 25 Issue: 2, 167 - 172, 30.08.2023
https://doi.org/10.18678/dtfd.1293886

Abstract

Amaç: Bu çalışmanın amacı, spinal anestezi altında sezaryen doğum yapan hastalarda ultrasonografi (USG) kılavuzluğunda uygulanan transversus abdominis plan (TAP) bloğun postoperatif analjezi, gastrointestinal motilite ve mobilizasyon zamanına etkisini araştırmaktır.
Gereç ve Yöntemler: Mart 2022 ile Haziran 2022 tarihleri arasında spinal anestezi altında elektif sezaryen doğum gerçekleştirmiş olan toplam 81 hastanın takip dosyaları geriye dönük olarak incelendi. Hastalar, 41 hasta TAP blok uygulanan grup (grup T) ve 40 hasta kontrol grubu (grup K) olmak üzere iki gruba ayrıldı. Hastaların demografik verileri, postoperatif dönem 2., 4., 6., 12. ve 24. saatlerdeki vizüel analog skala (VAS) değerleri, tramadol gereksinimleri, non-steroid anti inflamatuar ilaç (NSAİİ) ve tramadol tüketimleri, postoperatif bulantı-kusma (postoperative nausea-vomiting, PONV) durumları, ilk gaz çıkış zamanları ile mobilizasyon zamanları analiz edildi.
Bulgular: Grup T’deki hastaların postoperatif 2., 4. ve 6. saatlerdeki VAS skorları grup K’ye göre anlamlı olarak daha düşüktü (p<0,001). Bununla birlikte grup T’deki hastalarda PONV görülme oranı (p=0,006), tramadol gereksinimi (p=0,002), tüketilen tramadol (p=0,003) ve NSAİİ (p<0,001) miktarı ile mobilizasyon süresi (p=0,005) anlamlı olarak düşük saptandı. Grup T'de ilk gaz çıkışına kadar geçen süre kısa olmakla birlikte anlamlı değildi (p=0,072).
Sonuç: USG kılavuzluğunda uygulanan TAP bloğun sezaryen doğum sonrası multimodal analjeziye önemli katkı sağladığını ve hastaların erken mobilizasyonuna ve gastrointestinal fonksiyonların geri dönüşüne katkı sağlayabileceğini düşünüyoruz.

References

  • Sinatra R. Causes and consequences of inadequate management of acute pain. Pain Med. 2010;11(12):1859-71.
  • McDonnell NJ, Keating ML, Muchatuta NA, Pavy TJ, Paech MJ. Analgesia after caesarean delivery. Anaesth Intensive Care. 2009;37(4):539‑51.
  • Mankikar MG, Sardesai SP, Ghodki PS. Ultrasound guided transversus abdominis plane block for post-operative analgesia in patients undergoing caesarean section. Indian J Anaesth. 2016;60(4):253-7.
  • Tan TT, Teoh WH, Woo DC, Ocampo CE, Shah MK, Sia AT. A randomised trial of the analgesic efficacy of ultrasoundguided transversus abdominis plane block after caesarean delivery under general anesthesia. Eur J Anaesthesiol. 2012;29(2):88-94.
  • Çetin Arslan H, Arslan K. Eras management in obstetric and gynecological interventions. In: Demir C, editor. Obstetrics and Gynecology II. Ankara: Akademisyen Publishing House; 2022. p.57-62.
  • Oksar M, Koyuncu O, Turhanoglu S, Temiz M, Oran MC. Transversus abdominis plane block as a component of multimodal analgesia for laparoscopic cholecystectomy. J Clin Anesth. 2016:34:72-8.
  • Edney JC, Lam H, Raval MV, Heiss KF, Austin TM. Implementation of an enhanced recovery program in pediatric laparoscopic colorectal patients does not worsen analgesia despite reduced perioperative opioids: a retrospective, matched, non-inferiority study. Reg Anesth Pain Med. 2019;44(1):123-9.
  • Sahin ÖF, Aksoy Y, Kaydu A, Gökçek E. The effect of bilateral TAP block administration on analgesic consumption in cesarean operations under spinal anesthesia. Ortadoğu Tıp Derg. 2018;10(2):149-53. Turkish.
  • Aydogmus M, Sinikoglu S, Naki M, Ocak N, Sanlı N, Alagol A. Comparison of analgesic efficiency between wound site infiltration and ultra-sound-guided transversus abdominis plane block after cesarean delivery under spinal anaesthesia. Hippokratia. 2014;18(1):28-31.
  • Hebbard P. Subcostal transversus abdominis plane block under ultrasound guidance. Anesth Analg. 2008;106(2):674-5.
  • Kalisch BJ, Lee S, Dabney BW. Outcomes of inpatient mobilization: a literature review. J Clin Nurs. 2014;23(11-12):1486-501.
  • Pereira Gomes Morais E, Riera R, Porfírio GJ, Macedo CR, Sarmento Vasconcelos V, Souza Pedrosa A, et al. Chewing gum for enhancing early recovery of bowel function after caesarean section. Cochrane Database Syst Rev. 2016;10(10):CD011562.
  • Small C, Laycock H. Acute postoperative pain management. Br J Surg. 2020;107(2):e70-80.
  • Beverly A, Kaye AD, Ljungqvist O, Urman RD. Essential elements of multimodal analgesia in enhanced recovery after surgery (ERAS) guidelines. Anesthesiol Clin. 2017;35(2):e115-43.
  • Baaj JM, Alsatli RA, Majaj HA, Babay ZA, Thallaj AK. Efficacy of ultrasound-guided transversus abdominis plane (TAP) block for post-cesarean section delivery analgesia. Middle East J Anaesthesiol. 2010;20(6):821-6.
  • Cansiz KH, Yedekçi AE, Sen H, Ozkan S, Dagli G. The effect of ultrasound guided transversus abdominis plane block for cesarean delivery on postoperative analgesic consumption. Gulhane Med J. 2015;57(2):121-4.
  • Belavy D, Cowlishaw PJ, Howes M, Phillips F. Ultrasound guided transversus abdominis plane block for analgesia after caesarean delivery. Br J Anaesth. 2009;103(5):726-30.
  • El-Dawlatly AA, Turkistani A, Kettner SC, Machata AM, Delvi MB, Thallaj A, et al. Ultrasound-guided transversus abdominis plane block: Description of a new technique and comparison with conventional systemic analgesia during laparoscopic cholecystectomy. Br J Anaesth. 2009;102(6):763-7.
  • Wu CL, King AB, Geiger TM, Grant MC, Grocott MPW, Gupta R, et al. American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on perioperative opioid minimization in opioid-Naïve patients. Anesth Analg. 2019;129(2):567-7.
  • Allen BFS, Jablonski PM, McEvoy MD, Ehrenfeld JM, Shi H, King AB, et al. Implementation of an Enhanced Recovery Protocol (ERP) is associated with an increase in the perioperative use of non-opioid multimodal analgesia for non-ERP patients. J Clin Anesth. 2020;62:109694.
  • Colvin LA, Bull F, Hales TG. Perioperative opioid analgesia-when is enough too much? A review of opioid-induced tolerance and hyperalgesia. Lancet. 2019;393(10180):1558-68.
  • Meylan N, Elia N, Lysakowski C, Tramèr MR. Benefit and risk of intrathecal morphine without local anaesthetic in patients undergoing major surgery: meta-analysis of randomized trials. Br J Anaesth. 2009;102(2):156-67.
  • Zhang L, Jia Z, Gao T, Wang Y, Zhao Y, Li J, et al. A randomized controlled trial evaluating the effects of transversus abdominis plane block with compound lidocaine hydrochloride injection on postoperative pain and opioid consumption and gastrointestinal motility in patients undergoing gynecological laparotomy. Front Mol Neurosci. 2023;16:967917.
  • Srivastava U, Verma S, Singh TK, Gupta A, Saxsena A, Jagar KD, et al. Efficacy of trans abdominis plane block for post cesarean delivery analgesia: A double-blind, randomized trial. Saudi J Anaesth. 2015;9(3):298-302.
  • Farooq M, Carey M. A case of liver trauma with a blunt regional anesthesia needle while performing transversus abdominis plane block. Reg Anesth Pain Med. 2008;33(3):274-5.
  • Lancaster P, Chadwick M. Liver trauma secondary to ultrasound-guided transversus abdominis plane block. Br J Anaesth. 2010;104(4):509-10.
  • Mukhtar K, Singh S. Transversus abdominis plane block for laparoscopic surgery. Br J Anaesth. 2009;102(1):143-4.
  • El-Boghdadly K, Pawa A, Chin KJ. Local anesthetic systemic toxicity: current perspectives. Local Reg Anesth. 2018;11:35-44.
There are 28 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Kadir Arslan 0000-0003-4061-0746

Hale Çetin Arslan 0000-0002-5392-2434

Muhammed Emir Yıldız 0009-0005-6624-044X

Ayça Sultan Şahin 0000-0002-7765-5297

Early Pub Date August 10, 2023
Publication Date August 30, 2023
Submission Date May 8, 2023
Published in Issue Year 2023 Volume: 25 Issue: 2

Cite

APA Arslan, K., Çetin Arslan, H., Yıldız, M. E., Şahin, A. S. (2023). Effects of Ultrasonography-Guided Transversus Abdominis Plane Block on Postoperative Analgesia, Gastrointestinal Motility, and Mobilization in Patients Delivering Cesarean Delivery Under Spinal Anesthesia: A Retrospective Study. Duzce Medical Journal, 25(2), 167-172. https://doi.org/10.18678/dtfd.1293886
AMA Arslan K, Çetin Arslan H, Yıldız ME, Şahin AS. Effects of Ultrasonography-Guided Transversus Abdominis Plane Block on Postoperative Analgesia, Gastrointestinal Motility, and Mobilization in Patients Delivering Cesarean Delivery Under Spinal Anesthesia: A Retrospective Study. Duzce Med J. August 2023;25(2):167-172. doi:10.18678/dtfd.1293886
Chicago Arslan, Kadir, Hale Çetin Arslan, Muhammed Emir Yıldız, and Ayça Sultan Şahin. “Effects of Ultrasonography-Guided Transversus Abdominis Plane Block on Postoperative Analgesia, Gastrointestinal Motility, and Mobilization in Patients Delivering Cesarean Delivery Under Spinal Anesthesia: A Retrospective Study”. Duzce Medical Journal 25, no. 2 (August 2023): 167-72. https://doi.org/10.18678/dtfd.1293886.
EndNote Arslan K, Çetin Arslan H, Yıldız ME, Şahin AS (August 1, 2023) Effects of Ultrasonography-Guided Transversus Abdominis Plane Block on Postoperative Analgesia, Gastrointestinal Motility, and Mobilization in Patients Delivering Cesarean Delivery Under Spinal Anesthesia: A Retrospective Study. Duzce Medical Journal 25 2 167–172.
IEEE K. Arslan, H. Çetin Arslan, M. E. Yıldız, and A. S. Şahin, “Effects of Ultrasonography-Guided Transversus Abdominis Plane Block on Postoperative Analgesia, Gastrointestinal Motility, and Mobilization in Patients Delivering Cesarean Delivery Under Spinal Anesthesia: A Retrospective Study”, Duzce Med J, vol. 25, no. 2, pp. 167–172, 2023, doi: 10.18678/dtfd.1293886.
ISNAD Arslan, Kadir et al. “Effects of Ultrasonography-Guided Transversus Abdominis Plane Block on Postoperative Analgesia, Gastrointestinal Motility, and Mobilization in Patients Delivering Cesarean Delivery Under Spinal Anesthesia: A Retrospective Study”. Duzce Medical Journal 25/2 (August 2023), 167-172. https://doi.org/10.18678/dtfd.1293886.
JAMA Arslan K, Çetin Arslan H, Yıldız ME, Şahin AS. Effects of Ultrasonography-Guided Transversus Abdominis Plane Block on Postoperative Analgesia, Gastrointestinal Motility, and Mobilization in Patients Delivering Cesarean Delivery Under Spinal Anesthesia: A Retrospective Study. Duzce Med J. 2023;25:167–172.
MLA Arslan, Kadir et al. “Effects of Ultrasonography-Guided Transversus Abdominis Plane Block on Postoperative Analgesia, Gastrointestinal Motility, and Mobilization in Patients Delivering Cesarean Delivery Under Spinal Anesthesia: A Retrospective Study”. Duzce Medical Journal, vol. 25, no. 2, 2023, pp. 167-72, doi:10.18678/dtfd.1293886.
Vancouver Arslan K, Çetin Arslan H, Yıldız ME, Şahin AS. Effects of Ultrasonography-Guided Transversus Abdominis Plane Block on Postoperative Analgesia, Gastrointestinal Motility, and Mobilization in Patients Delivering Cesarean Delivery Under Spinal Anesthesia: A Retrospective Study. Duzce Med J. 2023;25(2):167-72.