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Ultrasound-guided versus surgical transversus abdominis plane block in obese patients following cesarean section: a prospective randomised study / Bloqueio cirúrgico do plano transverso abdominal versus guiado por ultrassom em pacientes obesas após cesárea: estudo prospectivo e randomizado
Urfalıoğlu, Aykut; Bakacak, Murat; Boran, Ömer Faruk; Yazar, Fatih Mehmet; Arslan, Mahmut; Öksüz, Hafize.
  • Urfalıoğlu, Aykut; Kahramanmaras Sutcu Imam University. School of Medicine. Department of Anesthesia and Reanimation. Kahramanmaras. TR
  • Bakacak, Murat; Kahramanmaras Sutcu Imam University. School of Medicine. Department of Anesthesia and Reanimation. Kahramanmaras. TR
  • Boran, Ömer Faruk; Kahramanmaras Sutcu Imam University. School of Medicine. Department of Anesthesia and Reanimation. Kahramanmaras. TR
  • Yazar, Fatih Mehmet; Kahramanmaras Sutcu Imam University. School of Medicine. Department of Anesthesia and Reanimation. Kahramanmaras. TR
  • Arslan, Mahmut; Kahramanmaras Sutcu Imam University. School of Medicine. Department of Anesthesia and Reanimation. Kahramanmaras. TR
  • Öksüz, Hafize; Kahramanmaras Sutcu Imam University. School of Medicine. Department of Anesthesia and Reanimation. Kahramanmaras. TR
Rev. bras. anestesiol ; 67(5): 480-486, Sept-Oct. 2017. tab, graf
Article in English | LILACS | ID: biblio-897763
ABSTRACT
Abstract Background and objectives Ultrasound-guided transversus abdominis plane block demonstrated efficacy in providing post-operative analgesia by prolonging the time to first analgesic requirement and reducing the total analgesic consumption. The surgical transversus abdominis plane block, a novel technique, can be performed safely in obese patients in whom muscle layers cannot be sufficiently exposed. Here, we compared applicability, efficacy and complications of surgical transversus abdominis plane and ultrasound-guided transversus abdominis plane blocks in obese pregnant women following cesarean section under general anesthesia. Methods Seventy-five pregnant women with pre- and post-pregnancy body mass index > 30 were randomized and allocated into two groups Ultrasound-guided transversus abdominis plane block (UT group; n = 38) and surgical TAP block (ST group; n = 37). Visual analogue scale scores at post-operative 0, 2, 6, 12 and 24 hours (h), time to first analgesic requirement, total analgesic consumption amount in 24 h, post-operative side effects, complications and patient satisfaction were recorded. Results and conclusions Age, American Society of Anesthesiologist score, operative duration, body mass index, mean time to first analgesic requirement and total analgesic consumption in 24 h were similar between groups, while significant differences in pre- and post-pregnancy body mass index were observed between groups. Block procedure durations were 7 and 10 minutes in ST and UT groups, respectively. No significant differences in visual analogue scale scores were observed between the groups at all times; itching and nausea was observed in one (UT group) and four (UT and ST groups) patients, respectively. Surgical transversus abdominis plane block was safe in obese pregnant patients and provided similar post-operative analgesia to ultrasound-guided transversus abdominis plane block.
RESUMO
Resumo Justificativa e objetivos O bloqueio do plano transverso abdominal (TAP) guiado por ultrassom (US) demonstrou eficácia no fornecimento de analgesia no pós-operatório ao prolongar o tempo até a primeira necessidade de analgésico e reduzir o consumo total de analgésico. O bloqueio TAP cirúrgico (uma nova técnica) pode ser realizado com segurança em pacientes obesas nas quais as camadas musculares não podem ser suficientemente expostas. Comparamos a aplicabilidade, a eficácia e as complicações do bloqueio TAP cirúrgico e do bloqueio TAP-US em gestantes obesas submetidas à cesárea sob anestesia geral. Método Setenta e cinco mulheres grávidas com índice de massa corporal (IMC) pré e pós-gravidez > 30 foram randomicamente alocadas em dois grupos bloqueio TAP-US (Grupo TAP-US, n = 38) e bloqueio TAP cirúrgico (Grupo TAP-C, n = 37). Os escores da escala visual analógica (VAS) nos tempos 0, 2, 6, 12 e 24 horas de pós-operatório, o tempo até a primeira necessidade de analgésico, o consumo total de analgésico em 24 horas, os efeitos colaterais no pós-operatório, as complicações e a satisfação do paciente foram registrados. Resultados e conclusões Idade, estado físico ASA, tempo cirúrgico, IMC, média de tempo até a primeira necessidade de analgésico e consumo total de analgésico em 24 horas foram semelhantes entre os grupos, enquanto diferenças significativas foram observadas entre os grupos em relação ao IMC pré- e pós-gravidez. As durações dos procedimentos de bloqueio foram de 7 e 10 minutos nos grupos TAP-US e TAP-C, respectivamente. Não houve diferença significativa nos escores VAS entre os grupos em todos os momentos; prurido e náusea foram observados em um paciente (Grupo TAP-US) e em quatro (Grupo TAP-C), respectivamente. O bloqueio TAP cirúrgico foi seguro nas pacientes grávidas obesas e forneceu analgesia similar à do bloqueio TAP-US no pós-operatório.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Pain, Postoperative / Pregnancy Complications / Cesarean Section / Ultrasonography, Interventional / Anesthesia, General / Anesthesia, Obstetrical / Nerve Block / Obesity Type of study: Controlled clinical trial / Observational study Limits: Adult / Female / Humans / Pregnancy Language: English Journal: Rev. bras. anestesiol Journal subject: Anesthesiology Year: 2017 Type: Article Affiliation country: Turkey Institution/Affiliation country: Kahramanmaras Sutcu Imam University/TR

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Full text: Available Index: LILACS (Americas) Main subject: Pain, Postoperative / Pregnancy Complications / Cesarean Section / Ultrasonography, Interventional / Anesthesia, General / Anesthesia, Obstetrical / Nerve Block / Obesity Type of study: Controlled clinical trial / Observational study Limits: Adult / Female / Humans / Pregnancy Language: English Journal: Rev. bras. anestesiol Journal subject: Anesthesiology Year: 2017 Type: Article Affiliation country: Turkey Institution/Affiliation country: Kahramanmaras Sutcu Imam University/TR