Obstetric Pain
Conditions
Keywords
transversus abdominis plane block (TAP block), postoperative analgesia, cesarean section
Brief summary
The transversus abdominis plane block (TAP block) has effect to postoperative analgesia for cesarean section with spinal anesthesia but it was limited for cesarean section with general anesthesia. The hypothesis that this technique has effect to postoperative analgesia for cesarean section with general anesthesia and it could reduce 50% of total morphine consumption during 24 hours after surgery.
Detailed description
This is a randomized, controlled, no-blind clinical trial. The investigators selected 60 cases, who were cesarean section under general anesthesia, age from18 years, and American Society Anesthesiologists (ASA) classification was from II-III. The cases of acute fetal impairment, local anesthesia contraindication, tolerance opioids, liver failure, renal failure, and spinal anesthesia failure were excluded. All cases were randomized assigned two groups: the TAP block group (T group) and controlled group (C group). Each group has 30 cases. The TAP block was performed under the ultrasound guidance with 0.25% of ropivacaine 20 ml each side. The both groups was treated postoperative analgesia with intravenous morphine to patients controlled analgesia (PCA). The primary outcome was total morphine consumption during 24 hours after surgery. The secondary outcomes were the time of required the first dose of morphine, pain score, the complications of TAP block, the side effects of morphine, and satisfaction score of participants. Data was described and analyzed with SPSS 25.0. The sample size was calculated with the hypothesis that TAP block could reduce 50% of dose morphine during 24 hours after surgery, 80% of power, 10% of loss, and 0.05 of alpha error.
Interventions
PROCEDURETAP block
TAP block was performed under guidance with 0.25% ropivacaine 20 ml each side.
DRUGMorphine
Single dose was 1 mg. The locked time was 6 minutes. The limited dose was 40 mg/ 4 giờ.
DRUGRopivacaine
Ropivacaine 0.25% 20 ml each side
Sponsors
Gia Dinh People Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Masking description
Participants were cesarean section with general anesthesia
Intervention model description
Transversus abdominis plane block under the ultrasound guidance
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 50 Years
Healthy volunteers
Yes
Inclusion criteria
* Cesarean section with general anesthesia. * The ASA classification was from II to III
Exclusion criteria
* The acute fetal impairment. * The severe live or renal failure. * Tolerance opioids
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total morphine consumption during 24 hours | 24 hours | Morphine was intravenous perfusion to participants during 24 hours with patients controlled analgesia (PCA). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The time required the first of dose of morphine (hours) | 24 hours | The time was from the end of surgery to the participants required the first of dose of morphine with PCA. |
| Pain score: VAS | 24 hours | Pain score was measured with visual analogue scale (VAS). VAS is from 0 to 10. The zero is complete non-pain and the ten is severe pain |
| The rate of complications of TAP block | 24 hours | There were rate of systemic toxicity, puncture peritonea, and hematomae in abdominal wall |
| The rate of side effect of morphine | 24 hours | There were rate of sedation, respiratory failure, nause and vomiting, pruritus |
| The satisfaction of participants: Likert | 24 hours | It was evaluated with Linkert score. Likerk score is from 1 to 5: 1-strongly disagree, 2-disagree, 3-neither agree nor disagree, 4-agree, 5-strongly agree |
Countries
Vietnam
Outcome results
None listed