Key result
Bilateral single-shot transversus abdominis plane blocks did not significantly reduce rescue oxycodone requirement compared to placebo (11.4% vs 20.5%, P=0.122) after caesarean delivery.
Why the study?
TAP blocks are increasingly used after caesarean delivery, but their effectiveness when combined with multimodal oral analgesia required evaluation.
Does ultrasound-guided bilateral single-shot TAP block reduce the need for rescue oxycodone in parturients undergoing elective caesarean delivery on multimodal oral analgesia?
RCT (n=159)
Double-blind
Block randomization
No
Does ultrasound-guided bilateral single-shot TAP block reduce the need for rescue oxycodone in parturients undergoing elective caesarean delivery on multimodal oral analgesia?
Bilateral single-shot TAP blocks do not significantly reduce the need for rescue oxycodone when added to a multimodal oral analgesic regimen after caesarean delivery under spinal anaesthesia.
Background: The transversus abdominis plane (TAP) block is used increasingly in parturients after caesarean delivery. This is a randomized controlled trial to evaluate the effectiveness of bilateral single-shot of TAP blocks in patients who received multimodal oral analgesia for postoperative pain relief.Methods: Parturients who were scheduled for elective caesarean delivery under spinal anaesthesia were recruited and randomized to receive bilateral single-shot of TAP blocks or placebo in addition to multimodal oral analgesia which consisted of regular tramadol, celecoxib and paracetamol, with oral oxycodone used as a rescue for breakthrough pain. Only parturients in the TAP group would receive the TAP blocks with an injection of 15ml (0.25%) ropivacaine on each side under aseptic techniques. All the parturients were evaluated for pain or related complications in the first 24 hours after surgery. The primary outcome is the percentage of parturients who required oxycodone as a rescue analgesia. Results: 80 and 79 parturients were allocated to the TAP and placebo group respectively. 9 out of 79 (11.4%) parturients in the TAP group and 15 out of 73 (20.5%) parturients in the placebo group required oxycodone for breakthrough pain, P = 0.122. Conclusions: Bilateral single-shot of TAP blocks confer little additional benefit when a multimodal oral analgesic regimen is used for pain control after caesarean section under spinal anaesthesia.Trial registration:Clinical Trial Registry of China (http://www.chictr.org.cn, ChiCTR-INR-16010130). Retrospective registered on Dec 12, 2016
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Yu et al. (2020) conducted an RCT in Postoperative pain after caesarean delivery (n=159). Bilateral single-shot transversus abdominis plane (TAP) block vs. Placebo (ultrasound scan without injection) plus multimodal oral analgesia was evaluated on Percentage of parturients requiring oxycodone as rescue analgesia (p=0.122). Bilateral single-shot transversus abdominis plane blocks did not significantly reduce rescue oxycodone requirement compared to placebo (11.4% vs 20.5%, P=0.122) after caesarean delivery.
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