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January 4, 2021Open Access

The Analgesic Efficacy of Ultrasound-guided Transversus Abdominis Plane (TAP) Block Combined With Oral Multimodal Analgesia In Comparison With Oral Multimodal Analgesia After Caesarean Delivery: A Randomized Controlled Trial

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Why the study?

Does bilateral single-shot TAP block reduce the requirement for rescue oxycodone in parturients receiving multimodal oral analgesia after caesarean delivery?

Population

159 parturients scheduled for elective caesarean delivery under spinal anaesthesia, mean age ~32.4 years…

Comparison

Ultrasound-guided bilateral single-shot… vs Placebo in addition to the same multimodal oral…

Design

RCT, An independent statistician prepared a randomization list while block of…

Follow-up

24 hours

Key result

Bilateral single-shot transversus abdominis plane blocks did not significantly reduce the need for rescue oxycodone compared to placebo (11.4% vs 20.5%, p=0.122) after caesarean delivery.

Authors

YYYang YuSGShenshan GaoVYVivian Manying Yuen

Discussion

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Overview

TAP blocks add no benefit to multimodal oral analgesia after cesarean; challenges routine use and supports opioid-sparing regimens alone.

Study Design

Type

RCT (n=159)

Blinding

Double-blind

Randomization

Block randomization with concealed opaque envelopes

Multicenter

No

Structured PICO

Does bilateral single-shot TAP block reduce the requirement for rescue oxycodone in parturients receiving multimodal oral analgesia after caesarean delivery?

P
Population
159 parturients scheduled for elective caesarean delivery under spinal anaesthesia, evaluated for postoperative pain and analgesic requirements over 24 hours.
I
Intervention
Ultrasound-guided bilateral single-shot transversus abdominis plane (TAP) blocks with 15ml (0.25%) ropivacaine on each side, in addition to multimodal oral analgesia (tramadol 100mg BID, celecoxib 200mg BID, paracetamol 1000mg QID, and oxycodone 10mg PRN).
C
Comparator
Placebo (ultrasound scan performed but no block administered) in addition to the same multimodal oral analgesia.
O
Outcome
Percentage of parturients who required oxycodone as a rescue analgesia in the first 24 hours after surgery.patient reported

Main Result

Absolute Event Rate: 11.4% vs 20.5%

p-value: p=0.122

Bilateral single-shot TAP blocks confer little additional benefit for reducing rescue analgesia requirements when a multimodal oral analgesic regimen is used after caesarean section under spinal anaesthesia.

Limitations

  • Difficult to exclude failed TAP blocks due to residual sensory block from spinal anesthesia
  • Some patients were excluded from the primary outcome analysis due to lost record sheets or failure to record data

Cite This Study

Yu et al. (2021) conducted an RCT in Postoperative pain after caesarean delivery (n=159). Ultrasound-guided bilateral single-shot transversus abdominis plane (TAP) block vs. Placebo was evaluated on Percentage of parturients who required oxycodone as a rescue analgesia (p=0.122). Bilateral single-shot transversus abdominis plane blocks did not significantly reduce the need for rescue oxycodone compared to placebo (11.4% vs 20.5%, p=0.122) after caesarean delivery.

synapsesocial.com/papers/6a97887b04c78a31a48bdee1https://doi.org/10.21203/rs.3.rs-50223/v4
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1The Analgesic Efficacy of Ultrasound-guided Transversus Abdominis Plane (TAP) Block Combined With Oral Multimodal Analgesia In Comparison With Oral Multimodal Analgesia After Caesarean Delivery: A Randomized Controlled Trial2020
  2. 2The Analgesic Efficacy of Ultrasound-guided Transversus Abdominis Plane (TAP) Block Combined With Oral Multimodal Analgesia In Comparison With Oral Multimodal Analgesia After Caesarean Delivery: A Randomized Controlled Trial2020
  3. 3The effect of transversus abdominal plane block on maternal–infant bonding after cesarean delivery: A randomized controlled study2026
  4. 4Efficacy of Trans Abdominis Plane (TAP) Block for Post-caesarean Delivery Analgesia: A Prospective Randomized Controlled Study2024
  5. 5Analgesic Effectiveness of Surgical Transversus Abdominis Plane Block after Cesarean Delivery2024