The transversus abdominis plane block in conjunction with intrathecal morphine use after cesarean section in women with severe pre-eclampsia: a randomized controlled trial
Abstract Background The transversus abdominis plane (TAP) block in conjunction with intrathecal morphine has been demonstrated to provide more superior postcesarean analgesia to intrathecal morphine alone. However, the analgesia efficacy of their conjunction has not been demonstrated in patients wit...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-03-01
|
| Series: | BMC Anesthesiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12871-023-02061-9 |
| _version_ | 1797853576801812480 |
|---|---|
| author | Zhi-rong Yan Li-juan Chen Su-jing Zhang Long-xin Zhang Huan Lu Li Zhang Ming Liu Min Zhou Li-hua Lin |
| author_facet | Zhi-rong Yan Li-juan Chen Su-jing Zhang Long-xin Zhang Huan Lu Li Zhang Ming Liu Min Zhou Li-hua Lin |
| author_sort | Zhi-rong Yan |
| collection | DOAJ |
| description | Abstract Background The transversus abdominis plane (TAP) block in conjunction with intrathecal morphine has been demonstrated to provide more superior postcesarean analgesia to intrathecal morphine alone. However, the analgesia efficacy of their conjunction has not been demonstrated in patients with severe pre-eclampsia. The study aimed to compare the postcesarean analgesia of TAP block in conjunction with intrathecal morphine versus intrathecal morphine alone in women with severe pre-eclampsia. Methods Pregnant women with severe pre-eclampsia undergoing planned cesarean section were randomly allocated into 2 groups to receive TAP block with 20 ml of 0.35% Ropivacaine (TAP group) or with the same volume of 0.9% saline (Sham group) after undergoing elective cesarean section under spinal anaesthesia with 15 mg of 0.5% Ropivacaine plus 0.1 mg of morphine. The outcomes for this analysis include the visual analog scale (VAS) pain score at rest and with movement at 4,8,12,24 h after TAP block was performed, times of use of intravenous patient-controlled analgesia (PCA) within 12 h after anesthesia, the occurrence of maternal side effects, maternal satisfaction, and Apgar score at 1 and 5 min of newborns. Results 119 subjects receive TAP block with 0.35% Ropivacaine (n = 59)or 0.9% saline (n = 60). At 4,8, 12 h after TAP block, the TAP group reported lower VAS score at rest [at 4 h: 1(0,1) vs. 1(1,2), P < 0.001; at 8 h:1(1,1) vs. 1(1.5,2),P < 0.001; at 12 h:1(1,2) vs. 2(1,2),P = 0.001] and higher satisfaction [53(89.9%) vs.45(75.0%), P < 0.05]. There were no differences between groups in VAS score at 24 h at rest and at all time points above with movement, times of use of PCA within 12 h after anesthesia, maternal side-effect, and Apgar score at 1 and 5 min of newborns. Conclusions In conclusion, The TAP block performed in conjunction with intrathecal morphine may not reduce opioid consumption, but it could reduce VAS scores at rest in the first 12 h after cesarean section in women with severe pre-eclampsia, and improve maternal satisfaction, which is worthy of clinical promotion. Trial registration Registered at Chinese Clinical Trial Registry( http://www.chictr.org.cn ) on 13/12/2021: ChiCTR2100054293. |
| first_indexed | 2024-04-09T19:52:53Z |
| format | Article |
| id | doaj.art-4977da48529940cf8c2926ae90bc3461 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-04-09T19:52:53Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-4977da48529940cf8c2926ae90bc34612023-04-03T05:38:27ZengBMCBMC Anesthesiology1471-22532023-03-012311710.1186/s12871-023-02061-9The transversus abdominis plane block in conjunction with intrathecal morphine use after cesarean section in women with severe pre-eclampsia: a randomized controlled trialZhi-rong Yan0Li-juan Chen1Su-jing Zhang2Long-xin Zhang3Huan Lu4Li Zhang5Ming Liu6Min Zhou7Li-hua Lin8Department of Anesthesiology, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fujian Medical UniversityDepartment of Child healthcare center, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fujian Medical UniversityDepartment of Anesthesiology, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fujian Medical UniversityDepartment of Anesthesiology, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fujian Medical UniversityDepartment of Anesthesiology, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fujian Medical UniversityDepartment of Anesthesiology, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fujian Medical UniversityDepartment of Anesthesiology, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fujian Medical UniversityDepartment of Anesthesiology, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fujian Medical UniversityDepartment of Healthcare, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Key Laboratory of Women and Children’s Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fujian Medical UniversityAbstract Background The transversus abdominis plane (TAP) block in conjunction with intrathecal morphine has been demonstrated to provide more superior postcesarean analgesia to intrathecal morphine alone. However, the analgesia efficacy of their conjunction has not been demonstrated in patients with severe pre-eclampsia. The study aimed to compare the postcesarean analgesia of TAP block in conjunction with intrathecal morphine versus intrathecal morphine alone in women with severe pre-eclampsia. Methods Pregnant women with severe pre-eclampsia undergoing planned cesarean section were randomly allocated into 2 groups to receive TAP block with 20 ml of 0.35% Ropivacaine (TAP group) or with the same volume of 0.9% saline (Sham group) after undergoing elective cesarean section under spinal anaesthesia with 15 mg of 0.5% Ropivacaine plus 0.1 mg of morphine. The outcomes for this analysis include the visual analog scale (VAS) pain score at rest and with movement at 4,8,12,24 h after TAP block was performed, times of use of intravenous patient-controlled analgesia (PCA) within 12 h after anesthesia, the occurrence of maternal side effects, maternal satisfaction, and Apgar score at 1 and 5 min of newborns. Results 119 subjects receive TAP block with 0.35% Ropivacaine (n = 59)or 0.9% saline (n = 60). At 4,8, 12 h after TAP block, the TAP group reported lower VAS score at rest [at 4 h: 1(0,1) vs. 1(1,2), P < 0.001; at 8 h:1(1,1) vs. 1(1.5,2),P < 0.001; at 12 h:1(1,2) vs. 2(1,2),P = 0.001] and higher satisfaction [53(89.9%) vs.45(75.0%), P < 0.05]. There were no differences between groups in VAS score at 24 h at rest and at all time points above with movement, times of use of PCA within 12 h after anesthesia, maternal side-effect, and Apgar score at 1 and 5 min of newborns. Conclusions In conclusion, The TAP block performed in conjunction with intrathecal morphine may not reduce opioid consumption, but it could reduce VAS scores at rest in the first 12 h after cesarean section in women with severe pre-eclampsia, and improve maternal satisfaction, which is worthy of clinical promotion. Trial registration Registered at Chinese Clinical Trial Registry( http://www.chictr.org.cn ) on 13/12/2021: ChiCTR2100054293.https://doi.org/10.1186/s12871-023-02061-9Severe pre-eclampsiaCesarean sectionIntrathecal morphineTransversus abdominis planePostoperative analgesia |
| spellingShingle | Zhi-rong Yan Li-juan Chen Su-jing Zhang Long-xin Zhang Huan Lu Li Zhang Ming Liu Min Zhou Li-hua Lin The transversus abdominis plane block in conjunction with intrathecal morphine use after cesarean section in women with severe pre-eclampsia: a randomized controlled trial BMC Anesthesiology Severe pre-eclampsia Cesarean section Intrathecal morphine Transversus abdominis plane Postoperative analgesia |
| title | The transversus abdominis plane block in conjunction with intrathecal morphine use after cesarean section in women with severe pre-eclampsia: a randomized controlled trial |
| title_full | The transversus abdominis plane block in conjunction with intrathecal morphine use after cesarean section in women with severe pre-eclampsia: a randomized controlled trial |
| title_fullStr | The transversus abdominis plane block in conjunction with intrathecal morphine use after cesarean section in women with severe pre-eclampsia: a randomized controlled trial |
| title_full_unstemmed | The transversus abdominis plane block in conjunction with intrathecal morphine use after cesarean section in women with severe pre-eclampsia: a randomized controlled trial |
| title_short | The transversus abdominis plane block in conjunction with intrathecal morphine use after cesarean section in women with severe pre-eclampsia: a randomized controlled trial |
| title_sort | transversus abdominis plane block in conjunction with intrathecal morphine use after cesarean section in women with severe pre eclampsia a randomized controlled trial |
| topic | Severe pre-eclampsia Cesarean section Intrathecal morphine Transversus abdominis plane Postoperative analgesia |
| url | https://doi.org/10.1186/s12871-023-02061-9 |
| work_keys_str_mv | AT zhirongyan thetransversusabdominisplaneblockinconjunctionwithintrathecalmorphineuseaftercesareansectioninwomenwithseverepreeclampsiaarandomizedcontrolledtrial AT lijuanchen thetransversusabdominisplaneblockinconjunctionwithintrathecalmorphineuseaftercesareansectioninwomenwithseverepreeclampsiaarandomizedcontrolledtrial AT sujingzhang thetransversusabdominisplaneblockinconjunctionwithintrathecalmorphineuseaftercesareansectioninwomenwithseverepreeclampsiaarandomizedcontrolledtrial AT longxinzhang thetransversusabdominisplaneblockinconjunctionwithintrathecalmorphineuseaftercesareansectioninwomenwithseverepreeclampsiaarandomizedcontrolledtrial AT huanlu thetransversusabdominisplaneblockinconjunctionwithintrathecalmorphineuseaftercesareansectioninwomenwithseverepreeclampsiaarandomizedcontrolledtrial AT lizhang thetransversusabdominisplaneblockinconjunctionwithintrathecalmorphineuseaftercesareansectioninwomenwithseverepreeclampsiaarandomizedcontrolledtrial AT mingliu thetransversusabdominisplaneblockinconjunctionwithintrathecalmorphineuseaftercesareansectioninwomenwithseverepreeclampsiaarandomizedcontrolledtrial AT minzhou thetransversusabdominisplaneblockinconjunctionwithintrathecalmorphineuseaftercesareansectioninwomenwithseverepreeclampsiaarandomizedcontrolledtrial AT lihualin thetransversusabdominisplaneblockinconjunctionwithintrathecalmorphineuseaftercesareansectioninwomenwithseverepreeclampsiaarandomizedcontrolledtrial AT zhirongyan transversusabdominisplaneblockinconjunctionwithintrathecalmorphineuseaftercesareansectioninwomenwithseverepreeclampsiaarandomizedcontrolledtrial AT lijuanchen transversusabdominisplaneblockinconjunctionwithintrathecalmorphineuseaftercesareansectioninwomenwithseverepreeclampsiaarandomizedcontrolledtrial AT sujingzhang transversusabdominisplaneblockinconjunctionwithintrathecalmorphineuseaftercesareansectioninwomenwithseverepreeclampsiaarandomizedcontrolledtrial AT longxinzhang transversusabdominisplaneblockinconjunctionwithintrathecalmorphineuseaftercesareansectioninwomenwithseverepreeclampsiaarandomizedcontrolledtrial AT huanlu transversusabdominisplaneblockinconjunctionwithintrathecalmorphineuseaftercesareansectioninwomenwithseverepreeclampsiaarandomizedcontrolledtrial AT lizhang transversusabdominisplaneblockinconjunctionwithintrathecalmorphineuseaftercesareansectioninwomenwithseverepreeclampsiaarandomizedcontrolledtrial AT mingliu transversusabdominisplaneblockinconjunctionwithintrathecalmorphineuseaftercesareansectioninwomenwithseverepreeclampsiaarandomizedcontrolledtrial AT minzhou transversusabdominisplaneblockinconjunctionwithintrathecalmorphineuseaftercesareansectioninwomenwithseverepreeclampsiaarandomizedcontrolledtrial AT lihualin transversusabdominisplaneblockinconjunctionwithintrathecalmorphineuseaftercesareansectioninwomenwithseverepreeclampsiaarandomizedcontrolledtrial |