Key result
Ultrasound-guided transversus abdominis plane block did not significantly reduce the requirement for rescue oxycodone compared to placebo (11.4% vs 20.5%, p=0.122) in parturients receiving multimodal oral analgesia after caesarean delivery.
Why the study?
The TAP block is increasingly used after caesarean delivery, but its effectiveness in patients receiving multimodal oral analgesia required evaluation.
Does ultrasound-guided TAP block reduce the requirement for oxycodone rescue analgesia in parturients receiving multimodal oral analgesia after elective caesarean delivery?
RCT (n=159)
Double-blind
Block randomization
No
Does ultrasound-guided TAP block reduce the requirement for oxycodone rescue analgesia in parturients receiving multimodal oral analgesia after elective caesarean delivery?
Answers are grounded in this paper and cite their sources.
Ultrasound-guided TAP block provides no significant additional reduction in rescue analgesic requirements when combined with a multimodal oral analgesic regimen after caesarean delivery.
Background: The transversus abdominis plane (TAP) block is used increasing in parturients after caesarean delivery. This is a randomized controlled trial to evaluate the effectivenss of TAP in patients who received multimodal oral analgesia for postoperative pain relief.Methods: Parturient who were scheduled for elective caesarean delivery under spinal anaesthesia were recruited and randomized to receive TAP block or placebo in addition to multimodal oral analgesia which consisted of regular tramadol, celecoxib and paracetamol, with oral oxycodone used as rescue for breakthrough pain. Only parturient in TAP group would have an injection of local anaesthesia under aseptic techniques. All the parturient were evaluated for pain or related complications in the first 24 hours after surgery. Results: Eighty and 79 parturients were allocated to TAP and placebo group respectively. Nine out of 79 (11.4%) and 15 out of 73 (20.5%) parturients required oxycodone for breakthrough pain, P = 0.122. There was no difference in postoperative pain score and patient satisfactory score between the two groups. Conclusions: TAP block confers little additional benefit when multi-modal oral analgesic regimen is used for postoperative 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). Ultrasound-guided Transversus Abdominis Plane (TAP) block vs. Placebo (sham block) plus multimodal oral analgesia was evaluated on Percentage of parturients who required oxycodone rescue analgesia for breakthrough pain in the first 24 hours (p=0.122). Ultrasound-guided transversus abdominis plane block did not significantly reduce the requirement for rescue oxycodone compared to placebo (11.4% vs 20.5%, p=0.122) in parturients receiving multimodal oral analgesia after caesarean delivery.
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