European journal of anaesthesiology · 2024
Ultrasound-guided transversalis fascia plane block or transversus abdominis plane block for recovery after caesarean section: A randomised clinical trial.
СтатьяРандомизированное исследованиеСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Pinarbaşi Ahmet, Altiparmak Başak, Korkmaz Toker Melike, Pirinççi Fatih, Uğur Bakiye
Аннотация
BACKGROUND: Caesarean section is a widely performed surgical procedure that often results in moderate-to-severe postoperative pain. If left untreated, this pain can lead to short-term and long-term consequences. Transversalis fascia plane (TFP) block and transversus abdominis plane (TAP) block are among the regional anaesthesia techniques employed for managing pain after a caesarean section.
OBJECTIVE: We aimed to compare the impact of these two blocks on the quality of recovery in patients undergoing elective caesarean section under spinal anaesthesia.
DESIGN: A single-centre, double-blind, randomised trial.
SETTINGS: Operating room, postanaesthesia recovery unit, and ward in a tertiary hospital.
PARTICIPANTS: Ninety-three patients (ASA 2 to 3) were recruited. After exclusion, 79 patients were included in the final analysis: 40 in the TFP block group and 39 in the TAP block group.
INTERVENTIONS: After surgery, participants received either TFP block (20 ml 0.25% bupivacaine for each side) or TAP block (20 ml 0.25% bupivacaine for each side).
MAIN OUTCOME MEASURES: The primary outcome was the difference in obstetric quality of recovery 11-Turkish (ObsQoR-11T) scores between groups. Secondary outcomes included pain scores, opioid consumption and incidence of opioid-related complications.
RESULTS: The mean ObsQoR-11T score was higher in the TFP block group compared with the TAP block group (97.13 ± 6.67 points vs. 87.10 ± 9.84 points, respectively; P < 0.001). The pain scores in the TFP block group were slightly lower between postoperative 4 and 24 h. The mean total morphine consumption was 15.08 ± 2.21 mg in the TFP block group and 22.21 ± 3.04 mg in the TAP block group ( P < 0.001). More patients required rescue analgesia between 4 and 8 h in the TAP block group [2.00 (5.00%) vs. 9.00 (23.08%), P = 0.02]. No significant differences were observed between groups in terms of opioid-related side effects.
CONCLUSION: TFP block used for analgesic purposes yielded a better quality recovery period than TAP block and also reduced opioid consumption.
TRIAL REGISTRATION: Clinicaltrials.gov (NCT05999981).
VISUAL ABSTRACT: http://links.lww.com/EJA/B6 .
OBJECTIVE: We aimed to compare the impact of these two blocks on the quality of recovery in patients undergoing elective caesarean section under spinal anaesthesia.
DESIGN: A single-centre, double-blind, randomised trial.
SETTINGS: Operating room, postanaesthesia recovery unit, and ward in a tertiary hospital.
PARTICIPANTS: Ninety-three patients (ASA 2 to 3) were recruited. After exclusion, 79 patients were included in the final analysis: 40 in the TFP block group and 39 in the TAP block group.
INTERVENTIONS: After surgery, participants received either TFP block (20 ml 0.25% bupivacaine for each side) or TAP block (20 ml 0.25% bupivacaine for each side).
MAIN OUTCOME MEASURES: The primary outcome was the difference in obstetric quality of recovery 11-Turkish (ObsQoR-11T) scores between groups. Secondary outcomes included pain scores, opioid consumption and incidence of opioid-related complications.
RESULTS: The mean ObsQoR-11T score was higher in the TFP block group compared with the TAP block group (97.13 ± 6.67 points vs. 87.10 ± 9.84 points, respectively; P < 0.001). The pain scores in the TFP block group were slightly lower between postoperative 4 and 24 h. The mean total morphine consumption was 15.08 ± 2.21 mg in the TFP block group and 22.21 ± 3.04 mg in the TAP block group ( P < 0.001). More patients required rescue analgesia between 4 and 8 h in the TAP block group [2.00 (5.00%) vs. 9.00 (23.08%), P = 0.02]. No significant differences were observed between groups in terms of opioid-related side effects.
CONCLUSION: TFP block used for analgesic purposes yielded a better quality recovery period than TAP block and also reduced opioid consumption.
TRIAL REGISTRATION: Clinicaltrials.gov (NCT05999981).
VISUAL ABSTRACT: http://links.lww.com/EJA/B6 .