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Çelik HK, Tulgar S, Bük ÖF, Koç K, Ünal M, Genç C, Süren M. Comparison of the analgesic efficacy of the ultrasound-guided transversalis fascia plane block and erector spinae plane block in patients undergoing open inguinal hernia repair under spinal anesthesia. Korean J Anesthesiol 2024; 77:255-264. [PMID: 38185619 PMCID: PMC10982532 DOI: 10.4097/kja.23404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 11/30/2023] [Accepted: 01/07/2024] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Open inguinal hernia repair (OIHR) surgery is a common surgical procedure, and ultrasound guided interfascial plane blocks can also be included in current approaches to postoperative multimodal analgesia regimens. This study aimed to compare the postoperative analgesic efficacy of the erector spinae plane block (ESPB) and transversalis fascia plane block (TFPB) in patients undergoing OIHR. METHODS This prospective, randomized, assessor-blinded comparative study was conducted in the postoperative recovery room and ward of a tertiary hospital. A total of 80 patients with American Society of Anesthesiologists physical status I-III were enrolled and allocated equally to either the ESPB or TFPB group. The patients received standard multimodal analgesia in addition to an ultrasound-guided ESPB or TFPB. During the first 24 h postoperatively, tramadol consumption was assessed and pain levels at rest and during movement were compared using numeric rating scale (NRS) scores at 1, 3, 6, 9, 12, 18, and 24 h postoperatively. RESULTS The results showed no difference in NRS scores at any time point between the groups, except for NRS at rest in the third hour. However, tramadol consumption was lower in the TFPB group than in the ESPB group overall (88 ± 75.2 vs. 131 ± 93.7 mg, respectively; P = 0.027, mean difference: -43, 95% CI [-80.82, -5.18]). CONCLUSIONS The TFPB leads to lower tramadol requirements in the first 24 h postoperatively than the ESPB in patients undergoing OIHR.
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Affiliation(s)
- Hale Kefeli Çelik
- Department of Anesthesiology and Reanimation, Samsun University Faculty of Medicine, Samsun Training and Research Hospital, Samsun, Turkey
| | - Serkan Tulgar
- Department of Anesthesiology and Reanimation, Samsun University Faculty of Medicine, Samsun Training and Research Hospital, Samsun, Turkey
| | - Ömer Faruk Bük
- Department of General Surgery, Samsun University Faculty of Medicine, Samsun Training and Research Hospital, Samsun, Turkey
| | - Kadem Koç
- Department of Anesthesiology and Reanimation, Samsun University Faculty of Medicine, Samsun Training and Research Hospital, Samsun, Turkey
| | - Murat Ünal
- Department of Anesthesiology and Reanimation, Samsun University Faculty of Medicine, Samsun Training and Research Hospital, Samsun, Turkey
| | - Caner Genç
- Department of Anesthesiology and Reanimation, Samsun University Faculty of Medicine, Samsun Training and Research Hospital, Samsun, Turkey
| | - Mustafa Süren
- Department of Anesthesiology and Reanimation, Samsun University Faculty of Medicine, Samsun Training and Research Hospital, Samsun, Turkey
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Sripriya R, Janani G, Sivashanmugam T. Comparison of ultrasound-guided transversalis fascia and posterior transversus abdominis plane block for postoperative analgesia following caesarean delivery: A double-blinded randomised controlled trial. Indian J Anaesth 2023; 67:893-900. [PMID: 38044921 PMCID: PMC10691614 DOI: 10.4103/ija.ija_931_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 08/21/2023] [Accepted: 08/23/2023] [Indexed: 12/05/2023] Open
Abstract
Background and Aims Posterior-transversus abdominus plane (TAP) block and transversalis fascia plane (TFP) block have been used for postoperative analgesia following caesarean delivery. We compared the analgesic efficacy of the TAP vs TFP plane blocks in patients undergoing elective caesarean delivery. Methods We randomised 90 women undergoing caesarean delivery under spinal anaesthesia to receive either a posterior-TAP (Group-TAP), TFP (Group-TFP) or no block (Group-C) postoperatively. The primary objective was the postoperative analgesic requirements. Secondary objectives were duration of analgesia, pain scores and infra-umbilical sensory loss, which were recorded at specific intervals for 24 h. Statistical analysis was carried out using Statistical Package for Social Sciences version 16.0 software. Results The patients requiring one, two or nil rescue analgesics were comparable between the interventions and the control (P = 0.32). The duration of analgesia was longer in Group-TAP when compared to Group-C, 4.76 (1.2) vs. 6.89 (2.4); P < 0.001, whereas Group-TFP, 5.64 (2.1) h, was not significantly different from Group-C. The static pain score in Group-TAP was significantly less than that in Group-C at 4 h and beyond 12 h (P < 0.001), whereas Group-TFP was comparable with Group-C at all time points except at 4 h and 24 h (P = 0.002). Only Group-TAP demonstrated midline infraumbilical sensory loss. Conclusion TAP and TFP blocks did not decrease the rescue analgesic requirement compared with the control group. The posterior-TAP block prolonged the duration of analgesia by 2 h, maintained the median static pain score at 0 beyond 12 h, and demonstrated sensory loss at the infraumbilical dermatomes.
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Affiliation(s)
- R Sripriya
- Department of Anaesthesiology, All India Institute of Medical Sciences, Mangalagiri, Guntur, Andhra Pradesh, India
| | - G Janani
- Department of Anaesthesiology and Critical Care, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pillaiyarkuppam, Puducherry, India
| | - T Sivashanmugam
- Department of Anaesthesiology and Critical Care, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pillaiyarkuppam, Puducherry, India
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Bilgin S, Aygun H, Genc C, Dost B, Tulgar S, Kaya C, Sertoz N, Koksal E. Comparison of ultrasound-guided transversalis fascia plane block and anterior quadratus lumborum block in patients undergoing caesarean delivery: a randomized study. BMC Anesthesiol 2023; 23:246. [PMID: 37480008 PMCID: PMC10362577 DOI: 10.1186/s12871-023-02206-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 07/13/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Cesarean section is becoming increasingly common. Well-managed postoperative analgesia improves patient comfort while encouraging early ambulation and breastfeeding. The analgesic efficacy of transversalis facial plane block (TFPB) vs. anterior quadratus lumborum block (QLB) was compared in this study. METHODS We analyzed the data of 49 pregnant women (gestation, ≥ 37weeks; age, 18-45years) scheduled for elective cesarean delivery (CD) under general anesthesia. They were randomly divided into TFPB and anterior QLB groups. All blocks were administered bilaterally with 25mL of 0.25% bupivacaine under ultrasound guidance prior to extubation. Postoperative morphine consumption and numerical rating scale (NRS) pain scores (static and dynamic [during coughing]) were recorded at 1, 3, 6, 9, 12, 18, and 24h. RESULTS There was no difference in postoperative morphine consumption between the groups at the third, sixth, and ninth hours, but the anterior QLB group consumed less morphine at the 12th, 18th, and 24th hours. Except for the first hour, resting and dynamic NRS scores were comparable between the groups. The first-hour resting and dynamic NRS scores were lower in the TFPB group (resting NRS, anterior QLB group, median [interquartile range], 2 [2-3] vs. TFPB group, 2 [0-2], p = 0.046; dynamic NRS, anterior QLB group, median [interquartile range], 3 [2-4] vs. TFPB group 2 [0-3], p = 0.001). CONCLUSIONS In patients undergoing CD, anterior QLB decreased morphine consumption in the late period (9-24h) compared to TFPB, while pain scores were similar between both groups. The reduction in morphine consumption was statistically significant, but not clinically significant.
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Affiliation(s)
- Sezgin Bilgin
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey, TR55139
| | - Hakan Aygun
- Department of Anesthesiology, Cigli Regional Training Hospital, Izmir, Turkey
| | - Caner Genc
- Department of Anesthesiology and Reanimation, Samsun Training and Research Hospital, Samsun, Turkey
| | - Burhan Dost
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey, TR55139.
| | - Serkan Tulgar
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Samsun Training and Research Hospital, Samsun University, Samsun, Turkey
| | - Cengiz Kaya
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey, TR55139
| | - Nezih Sertoz
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Ersin Koksal
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey, TR55139
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Abdelbaser I, Salah DM, Ateyya AA, Abdo MI. Ultrasound-guided transversalis fascia plane block versus lateral quadratus lumborum plane block for analgesia after inguinal herniotomy in children: a randomized controlled non-inferiority study. BMC Anesthesiol 2023; 23:82. [PMID: 36932317 PMCID: PMC10022034 DOI: 10.1186/s12871-023-02043-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 03/13/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Surgical repair of inguinal hernia is one of the most common day case surgeries in the pediatric population. This study compared the postoperative analgesic effects of transversalis fascia plane block (TFB) versus quadratus lumborum block (QLB) in children scheduled for open unilateral inguinal herniotomy. METHODS In this prospective, randomized, double-blind, controlled non-inferiority study, 76 eligible patients were recruited. Patients were randomly allocated to either the TFB or QLB group. The primary outcome measure was the proportion of patients who needed rescue analgesia during the first postoperative 12 h. The secondary outcomes were, the time needed to perform the block, the postoperative FLACC score, intraoperative heart rate (HR) and mean arterial pressure (MAP). RESULTS The proportion of patients who required a rescue analgesic was comparable (p = 1.000) between the TFB group (7/34, 20.5%) and the QLB group (6/34, 17.6%). The median [Q1-Q3] time needed to perform the block (min) was significantly longer (p < 0.001) in the QLB group (5[5]) compared with the TFB group. The postoperative FLACC pain scale was comparable between the two groups at all-time points of assessment. There is no difference regarding the heart rate and mean arterial blood pressure values at the time points that the values were recorded. (P > 0.005). CONCLUSIONS Both TFB and QLB similarly provide good postoperative analgesia by reducing the proportion of patients who required rescue analgesia, pain scores and analgesic consumption. Moreover, TFB is technically easier than QLB.
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Affiliation(s)
- Ibrahim Abdelbaser
- Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, 2 El-Gomhouria Street, Mansoura, 35516, Egypt.
| | - Doaa Mahmoud Salah
- Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, 2 El-Gomhouria Street, Mansoura, 35516, Egypt
| | - Amer Abdullah Ateyya
- Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, 2 El-Gomhouria Street, Mansoura, 35516, Egypt
| | - Marwa Ibrahim Abdo
- Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, 2 El-Gomhouria Street, Mansoura, 35516, Egypt
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Celik EC, Ozbey I, Aydin ME, Yayik AM, Oral Ahiskalioglu E, Tor IH, Ahiskalioglu A. Efficacy of transversalis fascia plane block as a novel ındication for varicocelectomy surgery: prospective randomized controlled study. BMC Anesthesiol 2023; 23:48. [PMID: 36750790 PMCID: PMC9903451 DOI: 10.1186/s12871-023-02009-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/03/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Varicocele occurs as a result of dilatation of the pampiniform plexus in the spermatic veins. In this study, our primary aim was to evaluate the effect of Transversalis Fascia Plane Block (TFPB) on pain scores in the postoperative period in patients undergoing varicocelectomy surgery, and our secondary aim was to evaluate the effect of TFPB on analgesic consumption. METHODS The study was initiated following local ethics committee approval, and sixty ASA I-II patients > 18y scheduled to undergo varicocelectomy and who consented to participation were enrolled. Before the procedure, the patients were randomly assigned two groups: Transversalis Fascia Plan block group (Group TFPB) or surgical incision site infiltration group (Group I).All surgeries were carried out under general anesthesia, and microsurgery using the subinguinal approach. After surgical suturing, TFPB and local infiltration blocks were applied prior to termination of anesthesia.For each block, 20 mL of 0.25% bupivacaine was utilized. Patients' demographic information, passive and active VAS ratings after surgery, usage of non steroidal anti-inflammatory medications and rescue analgesia, and the requirement for rescue analgesia, were recorded. RESULTS A total of 60 patients were included in the study. In terms of demographic data, there was no difference between the groups. At all hours, there was a statistically significant decrease in favor of Group TFPB in terms of active and passive VAS scores (p < 0.001), non steroidal anti-inflammatory analgesic use (p < 0.05), and tramadol requirement (p < 0.001). CONCLUSION This study has shown that TFPB can provide a more effective analgesia when compared to surgical site infiltration.
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Affiliation(s)
- Erkan Cem Celik
- Medical Faculty of Atatürk University, Deparment of Anesthesiology and Reanimation, Erzurum, Turkey. .,Clinical Research, Development and Design Application and Research Center, Ataturk University School of Medicine, Erzurum, Turkey.
| | - Isa Ozbey
- grid.411445.10000 0001 0775 759XMedical Faculty of Atatürk University, Department of Urology, Erzurum, Turkey
| | - Muhammed Enes Aydin
- grid.411445.10000 0001 0775 759XMedical Faculty of Atatürk University, Deparment of Anesthesiology and Reanimation, Erzurum, Turkey ,grid.411445.10000 0001 0775 759XClinical Research, Development and Design Application and Research Center, Ataturk University School of Medicine, Erzurum, Turkey
| | - Ahmet Murat Yayik
- grid.411445.10000 0001 0775 759XMedical Faculty of Atatürk University, Deparment of Anesthesiology and Reanimation, Erzurum, Turkey ,grid.411445.10000 0001 0775 759XClinical Research, Development and Design Application and Research Center, Ataturk University School of Medicine, Erzurum, Turkey
| | - Elif Oral Ahiskalioglu
- grid.411445.10000 0001 0775 759XMedical Faculty of Atatürk University, Deparment of Anesthesiology and Reanimation, Erzurum, Turkey ,grid.411445.10000 0001 0775 759XClinical Research, Development and Design Application and Research Center, Ataturk University School of Medicine, Erzurum, Turkey
| | - Ibrahim Hakki Tor
- grid.414570.30000 0004 0446 7716Deparment of Anesthesiology and Reanimation, Medical Faculty of University of Health Sciences, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Ali Ahiskalioglu
- grid.411445.10000 0001 0775 759XMedical Faculty of Atatürk University, Deparment of Anesthesiology and Reanimation, Erzurum, Turkey ,grid.411445.10000 0001 0775 759XClinical Research, Development and Design Application and Research Center, Ataturk University School of Medicine, Erzurum, Turkey
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Shao P, Li H, Shi R, Li J, Wang Y. Understanding fascial anatomy and interfascial communication: implications in regional anesthesia. J Anesth 2022; 36:554-563. [PMID: 35697947 DOI: 10.1007/s00540-022-03082-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 05/26/2022] [Indexed: 11/30/2022]
Abstract
With the extensive application of ultrasound in regional anesthesia, there has been rapid development of interfascial plane block techniques recently. Compared with neuraxial anesthesia or nerve plexus blocks, the interfascial plane blocks have many advantages, such as technical simplicity, fewer complications and comparable or better analgesia. The concept of fascial interconnectivity is fundamental in understanding the effects and complications of interfascial plane blocks. Many fascial planes are continuous and communicate with each other without a clear anatomical boundary. The prevertebral fascia of the neck, endothoracic fascia of the chest, transversalis fascia of the abdomen, and the fascia iliaca of the pelvic cavity form a natural fascial continuation. This anatomical feature suggests that the space beneath the cervical prevertebral fascia, the thoracic paravertebral space, the space between transversalis fascia and psoas muscles (psoas major and quadratus lumborum), and the fascia iliaca compartment are a confluent potential cavity. Additionally, the permeability of the fascia at different anatomical locations to local anesthetics is different, which can also influence the block effect and the incidence of complications. This article summarizes the anatomical characteristics and communication relationships of the major fascia which are related to regional anesthesia, and their relationships with block effects and complications.
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Affiliation(s)
- Peiqi Shao
- Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Huili Li
- Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Rong Shi
- Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Jinlei Li
- Department of Anesthesiology, Yale University School of Medicine, New Haven, CT, USA
| | - Yun Wang
- Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China.
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Ryu C, Choi GJ, Jung YH, Baek CW, Cho CK, Kang H. Postoperative Analgesic Effectiveness of Peripheral Nerve Blocks in Cesarean Delivery: A Systematic Review and Network Meta-Analysis. J Pers Med 2022; 12:jpm12040634. [PMID: 35455750 PMCID: PMC9033028 DOI: 10.3390/jpm12040634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/05/2022] [Accepted: 04/10/2022] [Indexed: 02/01/2023] Open
Abstract
The purpose of this systematic review and network meta-analysis was to determine the analgesic effectiveness of peripheral nerve blocks (PNBs), including each anatomical approach, with or without intrathecal morphine (ITMP) in cesarean delivery (CD). All relevant randomized controlled trials comparing the analgesic effectiveness of PNBs with or without ITMP after CD until July 2021. The two co-primary outcomes were designated as (1) pain at rest 6 h after surgery and (2) postoperative cumulative 24-h morphine equivalent consumption. Secondary outcomes were the time to first analgesic request, pain at rest 24 h, and dynamic pain 6 and 24 h after surgery. Seventy-six studies (6278 women) were analyzed. The combined ilioinguinal nerve and anterior transversus abdominis plane (II-aTAP) block in conjunction with ITMP had the highest SUCRA (surface under the cumulative ranking curve) values for postoperative rest pain at 6 h (88.4%) and 24-h morphine consumption (99.4%). Additionally, ITMP, ilioinguinal-iliohypogastric nerve block in conjunction with ITMP, lateral TAP block, and wound infiltration (WI) or continuous infusion (WC) below the fascia also showed a significant reduction in two co-primary outcomes. Only the II-aTAP block had a statistically significant additional analgesic effect compared to ITMP alone on rest pain at 6 h after surgery (−7.60 (−12.49, −2.70)). In conclusion, combined II-aTAP block in conjunction with ITMP is the most effective post-cesarean analgesic strategy with lower rest pain at 6 h and cumulative 24-h morphine consumption. Using the six described analgesic strategies for postoperative pain management after CD is considered reasonable. Lateral TAP block, WI, and WC below the fascia may be useful alternatives in patients with a history of sensitivity or severe adverse effects to opioids or when the CD is conducted under general anesthesia.
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Affiliation(s)
- Choongun Ryu
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul 06911, Korea; (C.R.); (G.J.C.); (Y.H.J.); (C.W.B.)
| | - Geun Joo Choi
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul 06911, Korea; (C.R.); (G.J.C.); (Y.H.J.); (C.W.B.)
| | - Yong Hun Jung
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul 06911, Korea; (C.R.); (G.J.C.); (Y.H.J.); (C.W.B.)
| | - Chong Wha Baek
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul 06911, Korea; (C.R.); (G.J.C.); (Y.H.J.); (C.W.B.)
| | - Choon Kyu Cho
- Department of Anesthesiology and Pain Medicine, College of Medicine, Konyang University, Daejeon 35365, Korea;
| | - Hyun Kang
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul 06911, Korea; (C.R.); (G.J.C.); (Y.H.J.); (C.W.B.)
- Correspondence: ; Tel.: +82-2-6299-2586
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Singh NP, Monks D, Makkar JK, Palanisamy A, Sultan P, Singh PM. Efficacy of regional blocks or local anaesthetic infiltration for analgesia after caesarean delivery: a network meta-analysis of randomised controlled trials. Anaesthesia 2021; 77:463-474. [PMID: 34958680 DOI: 10.1111/anae.15645] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2021] [Indexed: 01/15/2023]
Abstract
Caesarean delivery is common and can cause severe postoperative pain but injection of local anaesthetic at various sites for regional blocks or local anaesthetic infiltration may reduce this. We aimed to compare and rank these sites. We searched PubMed, Google Scholar, EMBASE and CENTRAL to June 2021 for randomised controlled trials and performed a random-effects Bayesian model network meta-analysis. The primary outcome was dose of parenteral morphine equivalents in the first 24 postoperative hours. We used surface under cumulative ranking probabilities to order techniques. We analysed 114 trials (8730 participants). The ordered mean (95% credible interval) reduction in morphine equivalents, from 34 mg with placebo, were as follows: ilio-inguinal 15 (1-32) mg; ilio-inguinal-iliohypogastric 13 (6-19) mg; transversalis fascia 11 (4-26) mg; erector spinae 11 (10-32); transverse abdominis 9 (4-13) mg; wound catheter infusion 8 (2-15) mg; quadratus lumborum 8 (1-15) mg; wound infiltration 8 (2-13) mg; and no intervention -4 (-10 to 2) mg. Ordered efficacies for injection sites were different for other relevant outcomes, including pain (to 4-6 h and to 24 h) and time to rescue analgesia: there was no single preferred route of injection. The ordered mean (95% credible interval) reduction in dynamic pain scores (0-10 scale) at 24 h compared with placebo were as follows: wound infusion 1.2 (0.2-2.1); erector spinae 1.3 (-0.5 to 3.1); quadratus lumborum 1.0 (0.1-1.8); ilio-inguinal-iliohypogastric 0.6 (-0.5 to 1.8); transverse abdominis 0.6 (-0.1 to 1.2); wound infiltration 0.5 (-0.3 to 1.3); transversalis fascia -0.8 (-3.4 to 1.9); ilio-inguinal -0.9 (-3.6 to 1.7); and no intervention -0.8 (-1.8 to 0.2). We categorised our confidence in effect sizes as low or very low.
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Affiliation(s)
- N P Singh
- Department of Anaesthesia, Maharishi Markandeshwar Institute of Medical Sciences and Research, Maharishi Markandeshwar University, Mullana-Ambala, India
| | - D Monks
- Department of Anesthesia, Washington University, Saint Louis, MO, USA
| | - J K Makkar
- Department of Anaesthesia and Intensive care, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - A Palanisamy
- Department of Anesthesia, Washington University, Saint Louis, MO, USA
| | - P Sultan
- Department of Anesthesia, Stanford University School of Medicine, Stanford, CA, USA
| | - P M Singh
- Department of Anesthesia, Washington University, Saint Louis, MO, USA
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9
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Koksal E, Aygun H, Genç C, Kaya C, Dost B. Comparison of the analgesic effects of two quadratus lumborum blocks (QLBs), QLB type II vs QLB type III, in caesarean delivery: A randomised study. Int J Clin Pract 2021; 75:e14513. [PMID: 34117829 DOI: 10.1111/ijcp.14513] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/31/2021] [Accepted: 06/06/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Quadratus lumborum blocks (QLBs) are relatively novel regional anaesthesia techniques, and the efficacy of all three types of QLB for postoperative analgesia in caesarean delivery (CD) has been demonstrated in separate studies. The aim of the present study is to compare the analgesic efficacy of the QLB-II and QLB-III blocks performed at the end of surgery in patients undergoing spinal anaesthesia for CD. METHODS We conducted a comparative, blinded, prospective, randomised and efficiency study. A total of 80 patients scheduled for elective CD under spinal anaesthesia were randomly allocated to receive either bilateral ultrasound-guided QLB-II or QLB-III block in a 1:1 ratio. The primary outcome was opioid consumption administered by a patient-controlled analgesia in the first 24 hours postoperatively. The secondary outcome of the study was pain intensity. Also, the time of first opioid requirement and the presence of nausea and vomiting were recorded. RESULTS Morphine consumption was statistically significantly lower in the QLB-III group when compared with the QLB-II group at the 3rd, 6th, 12th and 24th hours (P < .001, P < .001, P = .004, and P = .015, respectively). The QLB-III group showed significantly lower pain scores at rest at the 1st, 3rd, 6th, 9th and 24th hours after surgery (P < .001, P < .001, P < .001, P = .007 and P < .001, respectively). The QLB-III group also showed significantly lower pain score on movement at all measurement times (P < .001). CONCLUSIONS The analgesic efficacy of QLB-III was superior to QLB-II in patients who had undergone CD under spinal anaesthesia without use of intrathecal opioids and nonsteroidal anti-inflammatory drugs.
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Affiliation(s)
- Ersin Koksal
- Department of Anaesthesiology and Reanimation, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Hakan Aygun
- Department of Anesthesiology, Cigli Regional Training Hospital, Izmir, Turkey
| | - Caner Genç
- Department of Anaesthesiology and Reanimation, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Cengiz Kaya
- Department of Anaesthesiology and Reanimation, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Burhan Dost
- Department of Anaesthesiology and Reanimation, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
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Aygun H, Ozturk NK, Ugur M, Aydin Y, Celik GI, Thomas DT, Tulgar S. Evaluation of ultrasound-guided bilateral low thoracic erector spinae plane block for postoperative analgesia in cesarean delivery patients: a prospective, randomized, controlled clinical trial. Braz J Anesthesiol 2021; 72:444-449. [PMID: 34411636 PMCID: PMC9373620 DOI: 10.1016/j.bjane.2021.07.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 07/16/2021] [Accepted: 07/24/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Erector spinae plane block (ESPB) is a recently described block. In many reports, ESPB has been reported to provide effective postoperative analgesia in patients undergoing cesarean delivery (CD). Herein, we compared the effectiveness of ESPB and control group in postoperative analgesia in patients undergoing CD under spinal anesthesia. METHODS This assessor blinded, prospective, randomized, efficiency study was conducted in the postoperative recovery room and ward at a tertiary university hospital. Eighty-six patients (ASA II-III) were recruited. Following exclusion, 80 patients were randomized into two equal groups (block and control group). Standard multimodal analgesia was performed in the control group while ESPB block was performed in the intervention (ESPB) group. Opioid consumption was measured and pain intensity between groups was compared using Numeric Rating Scores (NRS). RESULTS NRS was lower in Group ESPB at 3rd and 6th hours. There was no difference between NRS scores at other hours. Opioid consumption was lower in Group ESPB. CONCLUSION When added to multimodal analgesia, bilateral ultrasound guided low thoracic ESPB leads to improve the quality of analgesia in the first 24 hours in patients undergoing CD.
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Affiliation(s)
- Hakan Aygun
- Cigli Regional Training Hospital, Department of Anesthesiology, Izmir, Turkey.
| | - Nilgun Kavrut Ozturk
- Antalya Training and Research Hospital, Department of Anesthesiology, Antalya, Turkey
| | - Murside Ugur
- Cigli Regional Training Hospital, Department of Anesthesiology, Izmir, Turkey
| | - Yeter Aydin
- Cigli Regional Training Hospital, Department of Obstetrics and Gynecology, Izmir, Turkey
| | - Gayem Inayet Celik
- Cigli Regional Training Hospital, Department of Obstetrics and Gynecology, Izmir, Turkey
| | - David Terence Thomas
- Maltepe University Faculty of Medicine, Department of Medical Education, Istanbul, Turkey
| | - Serkan Tulgar
- Maltepe University Faculty of Medicine, Department of Anesthesiology, Istanbul, Turkey
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Singh NP, Makkar JK, Bhatia N, Singh PM. The analgesic effectiveness of ilioinguinal-iliohypogastric block for caesarean delivery: A meta-analysis and trial sequential analysis. Eur J Anaesthesiol 2021; 38:S87-S96. [PMID: 33186313 DOI: 10.1097/eja.0000000000001379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND An effective analgesia strategy following caesarean delivery should be designed to improve fetomaternal outcomes. Much recent research has focused on the efficacy of ilioinguinal-iliohypogastric (II-IH) block for providing such analgesia. DESIGN A systematic review and meta-analysis of randomised controlled trials. OBJECTIVES To investigate the effectiveness of II-IH block in patients undergoing caesarean delivery. The primary outcome was the cumulative parenteral morphine equivalents at 24 h. Pain scores at 4 to 6 and 24 h postsurgery, time to first rescue analgesia and adverse effects were the secondary outcomes analysed. DATA SOURCES Two reviewers searched independently PubMed, Embase, Google Scholar and the Cochrane central registers of a controlled trial from their inception until June 2020. METHODOLOGY Prospective randomised control trials comparing II-IH block with either systemic analgesia alone or a placebo block (non-active controls) were eligible for inclusion. Only trials that reported their methods comprehensibly and transparently were included. Cochrane methodology was used to assess the risk of bias. Data are presented as mean difference with 95% confidence interval (CI). RESULTS Thirteen trials comprising a total of 858 patients were included. Opioid (intravenous morphine equivalents) consumption was reduced by 15.57 mg (95% CI -19.87 to -11.28; P < 0.00001; I2 = 95%) during the first 24 h in patients receiving II-IH block when compared with placebo or no block. Patients receiving general anaesthesia showed a greater reduction in morphine requirement at 24 h than those receiving neuraxial anaesthesia. Adequate 'information size' for the above outcome was confirmed with trial sequential analysis to rule out the possibility of a false-positive result. II-IH also significantly reduced pain scores at rest more so at 4 to 6 h than at 24 h. CONCLUSIONS Our study suggests that the use of II-IH blocks is associated with a lower 24 h requirement for intravenous morphine equivalents in patients undergoing caesarean delivery. However, given the methodological limitations, data should be interpreted with caution until more studies are available.
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Affiliation(s)
- Narinder P Singh
- From the Department of Anaesthesia, MMIMSR, MM (DU), Mullana-Ambala (NPS), the Department of Anaesthesia and Intensive care, Post Graduate Institute of Medical Education and Research, Chandigarh, India (JKM, NB) and the Department of Anesthesia, Washington University, Saint Louis, Missouri, USA (PMS)
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12
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Wang J, Zhao G, Song G, Liu J. The Efficacy and Safety of Local Anesthetic Techniques for Postoperative Analgesia After Cesarean Section: A Bayesian Network Meta-Analysis of Randomized Controlled Trials. J Pain Res 2021; 14:1559-1572. [PMID: 34103981 PMCID: PMC8180269 DOI: 10.2147/jpr.s313972] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 05/21/2021] [Indexed: 12/12/2022] Open
Abstract
Objective Cesarean section (CS) is one of the most frequently performed major surgical interventions. Local anesthetic techniques, a universal component of perioperative multimodal analgesia, are reportedly effective in reducing pain scores and opioid requirements. However, the optimal local anesthetic technique for postoperative CS pain remains unclear. Methods Six databases were searched, and a Bayesian network meta-analysis was performed. The outcomes included cumulative morphine consumption and pain scores at four time points, time to first analgesic request, postoperative nausea and vomiting, pruritus, and sedation. Results Sixty-eight studies with 5039 pregnant women were included. Six local anesthetic techniques were involved, including transversus abdominis plane block (TAPB), ilioinguinal and iliohypogastric nerve block, quadratus lumborum blocks, transversalis fascia plane block, erector spinae block, and wound infiltration. Compared to inactive controls, TAPB reduced cumulative morphine consumption at 6, 12, 24, and 48 h, pain scores at 6, 12, and 24 h (with the exception of 24 h at rest), the risk of postoperative nausea and vomiting, and sedation. Compared with inactive controls, ilioinguinal and iliohypogastric nerve block reduced cumulative morphine consumption at 6 and 24 h and pain scores at 6, 12, and 24 h during movement. Compared with inactive controls, quadratus lumborum blocks reduced cumulative morphine consumption at 24 and 48 h and pain scores at 6 and 12 h and lengthened the time to first analgesic request. Compared with inactive controls, wound infiltration reduced cumulative morphine consumption at 12 and 24 h, pain scores at 12 and 24 h during movement, and risk of sedation. Compared with inactive controls, erector spinae block reduced pain scores at 6 and 12 h. Transversalis fascia plane block was found to have similar outcomes to inactive controls. Conclusion TAPB is the most comprehensive local anesthetic technique for postoperative CS analgesia in the absence of intrathecal morphine.
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Affiliation(s)
- Jian Wang
- Department of Anesthesiology, The First Affiliated Hospital of China Medical University, Shenyang, People's Republic of China
| | - Ge Zhao
- Department of Obstetrics, The First Affiliated Hospital of China Medical University, Shenyang, People's Republic of China
| | - Guang Song
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Jing Liu
- Department of Obstetrics, The First Affiliated Hospital of China Medical University, Shenyang, People's Republic of China
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13
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Subarachnoid block and ultrasound-guided transversalis fascia plane block for caesarean section: A randomised, double-blind, placebo-controlled trial. Eur J Anaesthesiol 2021; 37:765-772. [PMID: 32412986 DOI: 10.1097/eja.0000000000001222] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND After caesarean section, maternal postoperative comfort is critical to allow the new mother to care for her baby. Insufficient pain relief during the postoperative period may delay maternal/infant bonding and, in addition, such pain has been linked to subsequent depression and chronic pain. Caesarean section is commonly performed with a Pfannenstiel incision, and a transversalis fascia plane (TFP) block provides postoperative analgesia in the T12 and L1 dermatomes. OBJECTIVE The aim of this study was to investigate the effect of the TFP block on postoperative opioid consumption and pain scores in patients undergoing caesarean section under spinal anaesthesia. DESIGN A randomised controlled, double-blind study. SETTINGS Single-centre, academic hospital. PARTICIPANTS Sixty patients undergoing caesarean section. INTERVENTIONS The TFP group (n = 30) received an ultrasound-guided bilateral TFP block with 20 ml of 0.25% bupivacaine. The control group (n = 30) received 20 ml of saline bilaterally. Postoperative analgesia was given every 6 h with intravenous paracetamol 1 g and patient-controlled analgesia (PCA) with morphine. MAIN OUTCOME MEASURES Postoperative visual analogue pain scores, morphine consumption, rescue analgesia and opioid-related side effects were evaluated. RESULTS In the TFP group, the visual analogue pain scores were significantly lower at rest for 2 h after the operation (P = 0.011) and during active movement at 2, 4 and 8 h postoperatively (P = 0.014, <0.001 and 0.032, respectively). Morphine consumption in the first 24 h after surgery was significantly higher in the control group compared with the TFP group (38.5 ± 11.63 and 19.5 ± 8.33 mg, respectively; P < 0.001). The incidence of postoperative nausea and constipation were statistically higher in the control group than in the TFP group (P < 0.05). Patient satisfaction was significantly higher in the TFP group (P = 0.027). CONCLUSION A postoperative TFP block can reduce opioid consumption and relieve acute pain after a caesarean section under spinal anaesthesia. TRIAL REGISTRATION ClinicalTrials.gov, NCT04172727.
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14
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Huang C, Zhang X, Dong C, Lian C, Li J, Yu L. Postoperative analgesic effects of the quadratus lumborum block III and transversalis fascia plane block in paediatric patients with developmental dysplasia of the hip undergoing open reduction surgeries: a double-blinded randomised controlled trial. BMJ Open 2021; 11:e038992. [PMID: 33542037 PMCID: PMC7925863 DOI: 10.1136/bmjopen-2020-038992] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To evaluate the analgesic effectiveness of two novel regional nerve blocks in paediatric patients with developmental dysplasia of the hip (DDH) after open reduction surgeries. DESIGN Prospective, double-blinded, randomised controlled trial. SETTING 2 tertiary teaching hospitals in China between August 2017 and July 2018. PARTICIPANTS 110 paediatric patients aged 2-10 years with DDH undergoing open reduction surgeries were recruited, 95 were randomised and 90 were included in the final analysis. INTERVENTIONS Random assignment to quadratus lumborum block III (QLB III) group, transversalis fascia plane block (TFPB) group and the control (no region nerve block) group. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was the Face, Legs, Activity, Cry and Consolability (FLACC) Scale Scores. Secondary outcomes included perioperative opioid consumption, the time until first press of nurse-controlled analgesia/patient-controlled analgesia (NCA/PCA) pump and the total counts number of pressing, length of postanaesthesia care unit (PACU) stay, length of hospital stay, parental satisfaction with pain management and adverse events. RESULTS Mean FLACC Scores were significantly lower in QLB III group and TFPB group while in the PACU and for 48 hours postoperatively, compared with control group (p<0.0001, p<0.0001, respectively). No differences were found for FLACC Scores between QLB III group and TFPB group, neither at rest (p=0.0402) nor while posture changing (p=0.0306). TFPB prolonged the first-time request for NCA/PCA analgesia, and decreased the total number of pressing counts, compared with QLB III (22.5 (16.2 to 28.7) vs 11.7 (6.6 to 16.8), p<0.0001; 2.4 (1.3 to 3.6) vs 3.8 (2.8 to 4.8), p=0.0111, respectively). No patient experienced any adverse events. CONCLUSIONS We suggested that both ultrasound-guided QLB III and TFPB should be considered as an option for perioperative analgesia in children with DDH undergoing open reduction surgeries. TFPB was superior to the QLB III because it prolonged the first-time request for NCA/PCA analgesia and decreased the total counts number of pressing. TRIAL REGISTRATION NUMBER NCT03189966/2017.
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Affiliation(s)
- Congcong Huang
- Department of Pain Management, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong, China
- Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University;Key Laboratory of Anesthesiology of Zhejiang Province, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiaoguang Zhang
- Department of Anesthesiology, Beijing Jishuitan Hospital, Beijing, China
| | - Chaoxuan Dong
- Department of Anesthesiology, First Affiliated Hospital of Jinan University and Guangzhou Overseas Chinese Hospital, Guangzhou, Guangdong, China
| | - Chunwei Lian
- Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University;Key Laboratory of Anesthesiology of Zhejiang Province, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jun Li
- Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University;Key Laboratory of Anesthesiology of Zhejiang Province, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lingzhi Yu
- Department of Pain Management, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong, China
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15
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Abdelbaser I, Mageed NA, El-Emam ESM, ALseoudy MM, Elmorsy MM. Preemptive analgesic efficacy of ultrasound-guided transversalis fascia plane block in children undergoing inguinal herniorrhaphy: a randomized, double-blind, controlled study. Korean J Anesthesiol 2020; 74:325-332. [PMID: 33307633 PMCID: PMC8342840 DOI: 10.4097/kja.20601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/13/2020] [Indexed: 12/18/2022] Open
Abstract
Background Surgical repair of congenital inguinal hernia results in significant postoperative discomfort and pain. The aim of the current study was to evaluate the pre-emptive analgesic efficacy of a transversalis fascia plane (TFP) block after pediatric inguinal herniorrhaphy. Methods Forty-four patients aged 12 to 60 months who underwent unilateral inguinal herniorrhaphy were enrolled. Four patients were excluded, and the remaining were allocated to the control group and the TFP block group. In the TFP block group, 0.4 ml/kg bupivacaine 0.25% was instilled in the plane between the transversus abdominis and transversalis fascia, while in the control group 0.9% saline was used instead of bupivacaine. The collected data were the total dose of paracetamol consumed during the first 12 h postoperatively, the postoperative Face, Leg, Activity, Cry, Consolability (FLACC) pain score, time to first use of rescue analgesia, number of patients required additional postoperative analgesics, and parents' satisfaction. Results The median paracetamol consumption was significantly lower in the TFP block group than in the control group, and FLACC pain scores were significantly lower for all study times in the TFP block group with higher parental satisfaction scores than those for the control group. The number of patients who required additional analgesics was significantly lower in the TFP block group than in the control group. Conclusions The use of a TFP block decreases postoperative analgesic consumption and postoperative pain intensity after pediatric inguinal herniorrhaphy. Future studies with larger sample size are required to evaluate the actual complications rate of TFP block.
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Affiliation(s)
- Ibrahim Abdelbaser
- Department of Anesthesia and Surgical Intensive Care, Mansoura University Faculty of Medicine, Mansoura, Egypt
| | - Nabil A Mageed
- Department of Anesthesia and Surgical Intensive Care, Mansoura University Faculty of Medicine, Mansoura, Egypt
| | - El-Sayed M El-Emam
- Department of Anesthesia and Surgical Intensive Care, Mansoura University Faculty of Medicine, Mansoura, Egypt
| | - Mahmoud M ALseoudy
- Department of Anesthesia and Surgical Intensive Care, Mansoura University Faculty of Medicine, Mansoura, Egypt
| | - Mohamed M Elmorsy
- Department of Anesthesia and Surgical Intensive Care, Mansoura University Faculty of Medicine, Mansoura, Egypt
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16
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Wilton J, Chiu H, Codianne N, Knapp H, Escolar VR, Burns S. Continuous quadratus lumborum block as post-operative strategy for pain control in spinal fusion surgery. Indian J Anaesth 2020; 64:869-873. [PMID: 33437075 PMCID: PMC7791409 DOI: 10.4103/ija.ija_476_20] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/05/2020] [Accepted: 07/12/2020] [Indexed: 11/04/2022] Open
Abstract
Background and Aims Lumbar spinal fusions have post-operative pain levels that can be difficult to treat. The objective of this study was to determine if using bilateral quadratus lumborum (QL) nerve block catheters for lumbar fusions changes the patient's post-operative recovery experience by reducing opioid consumption, thereby limiting potential risks and side effects and reducing recovery time. Methods There were a total of 52 surgical lumbar fusion patients in this single-center, retrospective cohort review. In control Group A, there were 26 patients who received opioid regimens. In control Group B, there were 26 patients who received bilateral QL block catheters with breakthrough opioid regimens. Forty-eight hour post-operative opioid use in oral morphine milligram equivalents (MME) and length of stay (LOS) from the post-anaesthesia care unit to hospital discharge were examined. Results Group A had a mean MME of 307.62 ± 305.37 mg. Group B had a statistically significant lower mean total MME of 133.78 ± 152.66 mg (P = 0.012, α = 0.05). On an average, Group A required 2.3 times the MMEs than Group B. Group A had a mean LOS of 2.34 ± 1.87 days, whereas Group B had a lower mean LOS of 1.98 ± 0.51 days. This difference of 0.36 days was not statistically significant (P = 0.522, α = 0.05). Conclusion Surgical lumbar fusion patients who received the QL block catheter had a lower opioid requirement compared to standard opioid regimens. The study was underpowered to detect a difference in LOS.
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Affiliation(s)
- Jon Wilton
- Department of Anaesthesia, Dignity Health Mercy Medical Center Mt. Shasta, Mount Shasta, Redding, USA
| | - Helen Chiu
- Department of Pharmacy, Dignity Health Mercy Medical Center Redding, Redding, USA
| | - Natalie Codianne
- Department of Pharmacy, Dignity Health Mercy Medical Center Mt. Shasta, Mount Shasta, USA
| | - Herschel Knapp
- Department of Clinical Informatics, Dignity Health Southern California Regional Office, CA, USA
| | - Vicente Roques Escolar
- Department of Anaesthesia and Intensive Care Medicine, Arrixaca University Clinical Hospital, Murcia, Spain
| | - Shari Burns
- Department of Nurse Anaesthesia, College of Health Sciences, Midwestern University, Glendale, AZ, USA
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Uppal V, Retter S, Kehoe E, McKeen DM. Quadratus lumborum block for postoperative analgesia: a systematic review and meta-analysis. Can J Anaesth 2020; 67:1557-1575. [DOI: 10.1007/s12630-020-01793-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 06/29/2020] [Accepted: 06/29/2020] [Indexed: 12/26/2022] Open
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Li C, Niu X, Chen F, Li L, Li Q, Xing B, Cui Y, Fan Q, Liu Y, Jia J. Ultrasound guided transverse fascial plane block (TFPB) via the superior lumbar triangle: Description of a new modified technique. J Clin Anesth 2020; 62:109735. [PMID: 32014758 DOI: 10.1016/j.jclinane.2020.109735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 01/25/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Chunyu Li
- Department of Anesthesiology, Heping Hospital affiliated to Changzhi Medical College, No. 110 South Yanan Road, Changzhi, Shanxi 046000, China.
| | - Xianglan Niu
- Department of basic medicine, Changzhi Medical College, No.161 Jiefang East Street, Changzhi, Shanxi 046000, China
| | - Fuqiang Chen
- Department of Anesthesiology, Heping Hospital affiliated to Changzhi Medical College, No. 110 South Yanan Road, Changzhi, Shanxi 046000, China
| | - Luoyun Li
- Department of Neurology, Changzhi Second People's Hospital, No.83 Heping West Street, Changzhi, Shanxi 046000, China
| | - Qingqing Li
- Department of Anesthesiology, Heping Hospital affiliated to Changzhi Medical College, No. 110 South Yanan Road, Changzhi, Shanxi 046000, China
| | - Baichun Xing
- Department of Anesthesiology, Heping Hospital affiliated to Changzhi Medical College, No. 110 South Yanan Road, Changzhi, Shanxi 046000, China
| | - Yalan Cui
- Department of Anesthesiology, Heping Hospital affiliated to Changzhi Medical College, No. 110 South Yanan Road, Changzhi, Shanxi 046000, China
| | - Qin Fan
- Department of Anesthesiology, Heping Hospital affiliated to Changzhi Medical College, No. 110 South Yanan Road, Changzhi, Shanxi 046000, China
| | - Yan Liu
- Department of Anesthesiology, Heping Hospital affiliated to Changzhi Medical College, No. 110 South Yanan Road, Changzhi, Shanxi 046000, China
| | - Jintai Jia
- Department of Anesthesiology, Heping Hospital affiliated to Changzhi Medical College, No. 110 South Yanan Road, Changzhi, Shanxi 046000, China.
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