Obstetric Anesthesia Problems, Obstetric Pain
Conditions
Keywords
transversus abdominis plane. VAS; visual analogue score; wound infiltration; cesarean section; postoperative pain; analgesia
Brief summary
Adequate pain control after cesarean delivery is a significant concern both for parturients and obstetric anesthesiologists. Transversus Abdominis Plane (TAP) block and local Wound infiltration with anesthetics are alternatives for reducing the severity of pain, total analgesic consumption, and opioid side effects. Both the TAP block and wound infiltration are superior to placebo; however, it is unknown which provides better analgesia after cesarean delivery because of a scarcity of randomized clinical trials. So, we hypothesized that the TAP block would decrease postoperative pain and postoperative cumulative opioid consumption at 24 hours
Interventions
PROCEDURETransversus Abdominis Plane Block
A 22-gauge spinal needle was introduced from medial to lateral in-plane to the ultrasound probe, and 20 mL of bupivacaine 0.25% was injected under visualization in the plane between the transversus abdominis muscle and the fascia deep to the internal oblique muscle on each side.
PROCEDURELocal anesthetic wound infiltration
40 mL of bupivacaine 0.25% was injected subcutaneously into the surgical wound (20 mL on each of the upper and lower sides) by the obstetrician before skin closure
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
19 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
1. Women who underwent cesarean section under spinal anesthesia. 2. Aged ≥19 years and less than 40 years. 3. Gestational age ≥ 37 Weeks.
Exclusion criteria
1. Body mass index (BMI) ≥40 kg/m2. 2. History of recent opioid exposure 3. Hypersensitivity to any of the drugs used in the study. 4. Significant cardiovascular, renal, or hepatic disease
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| degree of pain at rest and on movement (hip flexion and coughing) at 2, 4, 6, 12, and 24 hours postoperatively | 24 hours | , using a visual analog scale (VAS) score for pain intensity reported on 0-10-point scale for analysis. (0 = no pain and 10 = the worst possible pain). |
Secondary
| Measure | Time frame |
|---|---|
| measures the time to the first postoperative opioid dose | 24 hours |
| cumulative opioid consumption at 2, 4, 6, and 12 hours. | 12 hours |
Countries
Egypt
Outcome results
None listed