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Comparison of Analgesic Effect Between Erector Spinae Plane Block and Transversus Abdominis Plane Block After Elective Cesarean Section: A Prospective Randomized Single-Blind Controlled Study.
J Pain Res. 2020; 13:1073-1080.JP

Abstract

Background

This study compared the analgesic efficacy of a bilateral erector spinae plane (ESP) block with that of a bilateral transversus abdominis plane (TAP) block after elective cesarean delivery.

Methods

Sixty mothers scheduled for elective cesarean delivery under spinal anesthesia were randomly allocated to receive either ESP block or TAP block. The ESP group received ESP block at the level of the ninth thoracic transverse process with 20 mL of 0.25% bupivacaine at the end of surgery. The TAP group received an ultrasound-guided TAP block with 20 mL of 0.25% bupivacaine on completion of delivery. The primary outcome was the duration of analgesia achieved by each block. Secondary outcome measures were the postoperative pain severity, total tramadol consumption, patient satisfaction.

Results

The median (interquartile range) duration of block was longer in the ESP group than in the TAP group (12 hours [10, 14] vs 8 hours [8, 8], p<0.0001). In the first 24 hours, the mean visual analog pain score at rest was lower by 0.32 units in the ESP group. The median tramadol consumption in the first 24 hours was significantly higher in the TAP group than in the ESP group (125 mg [100, 150] vs 100 mg [75, 100, p=0.003]).

Conclusion

Compared with the TAP block, the ESP block provides more effective pain relief, has a longer duration of analgesic action, prolongs time to first analgesic requirement, is associated with less tramadol consumption, and can be used in multimodal analgesia and opioid-sparing regimens after cesarean section.

Authors+Show Affiliations

Department of Anesthesiology, Faculty of Medicine, Fayoum University, Cairo, Egypt.Department of Anesthesiology, Faculty of Medicine, Fayoum University, Cairo, Egypt.Department of Anesthesiology, Faculty of Medicine, Fayoum University, Cairo, Egypt.Department of Anesthesiology, Faculty of Medicine, Fayoum University, Cairo, Egypt.Department of Anesthesiology, Faculty of Medicine, Fayoum University, Cairo, Egypt.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32547172

Citation

Boules, Maged Labib, et al. "Comparison of Analgesic Effect Between Erector Spinae Plane Block and Transversus Abdominis Plane Block After Elective Cesarean Section: a Prospective Randomized Single-Blind Controlled Study." Journal of Pain Research, vol. 13, 2020, pp. 1073-1080.
Boules ML, Goda AS, Abdelhady MA, et al. Comparison of Analgesic Effect Between Erector Spinae Plane Block and Transversus Abdominis Plane Block After Elective Cesarean Section: A Prospective Randomized Single-Blind Controlled Study. J Pain Res. 2020;13:1073-1080.
Boules, M. L., Goda, A. S., Abdelhady, M. A., Abu El-Nour Abd El-Azeem, S. A., & Hamed, M. A. (2020). Comparison of Analgesic Effect Between Erector Spinae Plane Block and Transversus Abdominis Plane Block After Elective Cesarean Section: A Prospective Randomized Single-Blind Controlled Study. Journal of Pain Research, 13, 1073-1080. https://doi.org/10.2147/JPR.S253343
Boules ML, et al. Comparison of Analgesic Effect Between Erector Spinae Plane Block and Transversus Abdominis Plane Block After Elective Cesarean Section: a Prospective Randomized Single-Blind Controlled Study. J Pain Res. 2020;13:1073-1080. PubMed PMID: 32547172.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of Analgesic Effect Between Erector Spinae Plane Block and Transversus Abdominis Plane Block After Elective Cesarean Section: A Prospective Randomized Single-Blind Controlled Study. AU - Boules,Maged Labib, AU - Goda,Abeer Shaban, AU - Abdelhady,Mahdy Ahmed, AU - Abu El-Nour Abd El-Azeem,Shimaa Adel, AU - Hamed,Mohamed Ahmed, Y1 - 2020/05/19/ PY - 2020/03/10/received PY - 2020/05/01/accepted PY - 2020/6/18/entrez PY - 2020/6/18/pubmed PY - 2020/6/18/medline KW - analgesia KW - cesarean KW - erector spinae plane block KW - tramadol KW - transversus abdominis plane block SP - 1073 EP - 1080 JF - Journal of pain research JO - J Pain Res VL - 13 N2 - Background: This study compared the analgesic efficacy of a bilateral erector spinae plane (ESP) block with that of a bilateral transversus abdominis plane (TAP) block after elective cesarean delivery. Methods: Sixty mothers scheduled for elective cesarean delivery under spinal anesthesia were randomly allocated to receive either ESP block or TAP block. The ESP group received ESP block at the level of the ninth thoracic transverse process with 20 mL of 0.25% bupivacaine at the end of surgery. The TAP group received an ultrasound-guided TAP block with 20 mL of 0.25% bupivacaine on completion of delivery. The primary outcome was the duration of analgesia achieved by each block. Secondary outcome measures were the postoperative pain severity, total tramadol consumption, patient satisfaction. Results: The median (interquartile range) duration of block was longer in the ESP group than in the TAP group (12 hours [10, 14] vs 8 hours [8, 8], p<0.0001). In the first 24 hours, the mean visual analog pain score at rest was lower by 0.32 units in the ESP group. The median tramadol consumption in the first 24 hours was significantly higher in the TAP group than in the ESP group (125 mg [100, 150] vs 100 mg [75, 100, p=0.003]). Conclusion: Compared with the TAP block, the ESP block provides more effective pain relief, has a longer duration of analgesic action, prolongs time to first analgesic requirement, is associated with less tramadol consumption, and can be used in multimodal analgesia and opioid-sparing regimens after cesarean section. SN - 1178-7090 UR - https://www.unboundmedicine.com/medline/citation/32547172/Comparison_of_Analgesic_Effect_Between_Erector_Spinae_Plane_Block_and_Transversus_Abdominis_Plane_Block_After_Elective_Cesarean_Section:_A_Prospective_Randomized_Single-Blind_Controlled_Study L2 - https://dx.doi.org/10.2147/JPR.S253343 DB - PRIME DP - Unbound Medicine ER -
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