Cesarean Section
Conditions
Keywords
c-section, cesarean section, TAP block, pain, pain after delivery, pain after C-section, pain after C-section delivery, pain after cesarean delivery, pain after cesarean
Brief summary
The purpose of this study is to determine if injecting a local anesthetic, or numbing medication, above each hip will decrease the amount of narcotic pain medicine that is typically required by a patient after a cesarean delivery. Ultrasound pictures will be used to guide placement of this injection. Either ropivicaine (a type of numbing medication called a local anesthetic) or a placebo (saline) will be injected. For 24 hours, you will be given a button to press when you have pain. When the button is pressed, you will be given a small amount of pain medication called hydromorphone through your IV. You will also be given a pain medication called ketorolac through your IV every 8 hours for 24 hours after surgery.
Interventions
DRUG0.5% ropivacaine
20ml each side of the hip of 0.5% ropivacaine into the transverse abdominis plane after patient is brought to the recovery area after elective cesarean delivery
DRUG0.9% sodium chloride
20ml each side of the hip of 0.9% sodium chloride into the transverse abdominis plane after patient is brought to the recovery area after elective cesarean delivery
Sponsors
Ochsner Health System
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age 18 years or over * ASA class 1 , 2 or 3 * BMI greater than 30 kg/m2 (as recorded at the patient's last clinic appointment or as measured on the day of delivery) * Scheduled for cesarean section via Pfannenstiel incision (with or without a tubal ligation) * 150 cm or taller * Informed consent obtained
Exclusion criteria
* ASA class 4 * Age under 18 * Relevant drug allergy * Contraindication to spinal anesthesia * Height \< 150 cm * Patient receiving medical therapies considered to result in a tolerance to opioids * Any other major surgical procedure performed other than cesarean delivery with or without tubal ligation * Patient with relevant contraindications to ketorolac, such as history of gastrointestinal bleeding or impaired renal function * Patient refusal
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| hydromorphone consumed by patient controlled analgesia in the first 24 hours after cesarean delivery | 24 hours |
Secondary
| Measure | Time frame |
|---|---|
| Categorical pain scores and Visual Analog Scale (VAS) pain scores (at rest and with movement), nausea and sedation will be assessed to evaluate narcotic side effects | 24 hours |
Countries
United States
Outcome results
None listed