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Regional Anesthesia Abdominal Blocks and Local Infiltration After Cesarean Delivery: Review of Current Evidence.
Curr Pain Headache Rep. 2021 Mar 24; 25(5):28.CP

Abstract

PURPOSE OF REVIEW

In this review, we discuss surgical infiltration and various abdominal wall blocks, including transversus abdominis plane (TAP) block and quadratus lumborum blocks, and review the literature on the evidence behind these approaches and analgesia for cesarean delivery (CD).

RECENT FINDINGS

Adequate pain management in the parturient following CD is important to facilitate early ambulation and neonatal care while also improving patient satisfaction and decreasing hospital length of stay. Neuraxial opioids have been a mainstay for postoperative analgesia; however, this option may not be available for patients undergoing emergency CD and have contraindications to neuraxial approaches, refusing an epidural or spinal, or with technical difficulties for neuraxial placement. In such cases, alternative options include a fascial plane block or surgical wound infiltration. The use of regional blocks or surgical wound infiltration is especially recommended in the parturient who does not receive neuraxial opioids for CD. Adequate postoperative analgesia following CD is an important component of the overall care of the parturient as it helps facilitate early mobilization and improve patient satisfaction. In conclusion, the use of abdominal fascial plane blocks or surgical wound infiltration is recommended in the parturient who does not receive neuraxial opioids for CD.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Gabriel RA
Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA. ragabriel@health.ucsd.edu. Division of Biomedical Informatics, University of California San Diego, La Jolla, CA, USA. ragabriel@health.ucsd.edu.
Burton BN
Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
Curran BP
Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA.
Urman RD
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA.

MeSH

Abdominal MusclesAbdominal WallAnalgesia, EpiduralAnalgesics, OpioidAnesthesia, ConductionAnesthesia, EpiduralAnesthetics, LocalCesarean SectionFemaleHumansLength of StayNerve BlockPain, PostoperativePregnancySurgical Wound

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

33761010

Citation

Gabriel, Rodney A., et al. "Regional Anesthesia Abdominal Blocks and Local Infiltration After Cesarean Delivery: Review of Current Evidence." Current Pain and Headache Reports, vol. 25, no. 5, 2021, p. 28.
Gabriel RA, Burton BN, Curran BP, et al. Regional Anesthesia Abdominal Blocks and Local Infiltration After Cesarean Delivery: Review of Current Evidence. Curr Pain Headache Rep. 2021;25(5):28.
Gabriel, R. A., Burton, B. N., Curran, B. P., & Urman, R. D. (2021). Regional Anesthesia Abdominal Blocks and Local Infiltration After Cesarean Delivery: Review of Current Evidence. Current Pain and Headache Reports, 25(5), 28. https://doi.org/10.1007/s11916-021-00945-4
Gabriel RA, et al. Regional Anesthesia Abdominal Blocks and Local Infiltration After Cesarean Delivery: Review of Current Evidence. Curr Pain Headache Rep. 2021 Mar 24;25(5):28. PubMed PMID: 33761010.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Regional Anesthesia Abdominal Blocks and Local Infiltration After Cesarean Delivery: Review of Current Evidence. AU - Gabriel,Rodney A, AU - Burton,Brittany N, AU - Curran,Brian P, AU - Urman,Richard D, Y1 - 2021/03/24/ PY - 2021/02/12/accepted PY - 2021/3/24/entrez PY - 2021/3/25/pubmed PY - 2021/11/18/medline KW - Quadratus lumborum block KW - Surgical infiltration KW - Transversus abdominis plane block SP - 28 EP - 28 JF - Current pain and headache reports JO - Curr Pain Headache Rep VL - 25 IS - 5 N2 - PURPOSE OF REVIEW: In this review, we discuss surgical infiltration and various abdominal wall blocks, including transversus abdominis plane (TAP) block and quadratus lumborum blocks, and review the literature on the evidence behind these approaches and analgesia for cesarean delivery (CD). RECENT FINDINGS: Adequate pain management in the parturient following CD is important to facilitate early ambulation and neonatal care while also improving patient satisfaction and decreasing hospital length of stay. Neuraxial opioids have been a mainstay for postoperative analgesia; however, this option may not be available for patients undergoing emergency CD and have contraindications to neuraxial approaches, refusing an epidural or spinal, or with technical difficulties for neuraxial placement. In such cases, alternative options include a fascial plane block or surgical wound infiltration. The use of regional blocks or surgical wound infiltration is especially recommended in the parturient who does not receive neuraxial opioids for CD. Adequate postoperative analgesia following CD is an important component of the overall care of the parturient as it helps facilitate early mobilization and improve patient satisfaction. In conclusion, the use of abdominal fascial plane blocks or surgical wound infiltration is recommended in the parturient who does not receive neuraxial opioids for CD. SN - 1534-3081 UR - https://www.unboundmedicine.com/medline/citation/33761010/Regional_Anesthesia_Abdominal_Blocks_and_Local_Infiltration_After_Cesarean_Delivery:_Review_of_Current_Evidence_ DB - PRIME DP - Unbound Medicine ER -