Post caesarean delivery pain control with bilateral ultrasound-guided transversus abdominis plane block using 18G intravenous cannula: a case report.
Abstract
In recent time ultrasound guided transversus abdominis plane block has become popular in the developing countries as option in post-operative pain management. Its use in multimodal setting spares the use of opioids and the associated side effects like sedation however; availability of materials could most time limits its routine use. We present a case of transversus abdominis plane block that was performed on a 36 year old female with America Society of Anaesthesiologist physical status classification II. She was a gravida 3 para 2 female with 2 previous Caesarean section. Transversus abdominis plane block (TAP) was administered with 18G intravenous
cannula needle because our stock of regional anaesthetic needle was exhausted at the time we intended conducting the block. Her weight and height, were 63kg, 1.57 meters. Transversus abdominis plane block in a multimodal setting was planned for the patient at preoperative anaesthetic review. This was because the patient specifically did not want any form of sedation in the post-operative period The Cesarean section was done under subarachnoid block. Immediately. after the surgery, it was observed that our stock of regional anaesthetic needle was exhausted. Consultation with the patient was made and consent was obtained to use available alternative. A Size 18G intravenous cannula needle was considered as alternative. It was therefore use in place of regional anaesthesic needle to access the transversus abdominis plane under ultrasound guide. After confirming the correct needle placement, bilateral in plane transversus abdominis plane block was conducted using a total of 40mL of 0.25% plain bupivacaine.
Downloads
References
1. Abdallah FW, Chan VW, Brull R. Transversus abdominis plane block: a systemic review. Reg Anesth Pain Med 2012; 37(3):193 - 209
2 Bhattacharjee S, Ray M, Ghose T, Maitra S, Layek A. Analgesic efficacy of transversus abdominal plane block in providing effective perioperative analgesia in patients undergoing total abdominal hysterectomy: A randomized controlled trial. J Anaesthesiol Clin Pharmacol. 2014; 30(3): 391 – 396.
3. Ripolles J, Mezquita MS, Abad A, Calvo J. Analgesic efficacy of ultrasound-guided blockade of the transversus abdominis plane – a systematic review. Rev Bras Anestesiol 2015; 65(4) 255 – 280
4. McDonnell JG, Curley G, Carney J, Benton A, Costello J, Maharaj CH, et al. The analgesic efficacy of transversus abdominis plane block after cesarean delivery: A randomized controlled trial. Anesth Anal g. 2008; 106(1):186–91
5. Baaj MJ, Alsatli AR, Majaj AH, Babay AZ TK. Efficacy of ultrasound- guided transversus abdominis plane (TAB) block for post- cesarean section delivery analgesia - A double- blind placebo-controlled trials. Middle East J Anesthsiol. 2010; 20(6):821–5.
6. Khedker SM, Bhalerao MP, Yemul- Golhar RS, Kelkar VK. Ultrasound guided -iloinguinal and iliohypogastric nerve block, a comparison with conventional technique: An observational study. Saudi J Anaesth 2015; 9:
293-297.
7. Ige OA, Bolaji BO, Kolawole K. Opioid – Sparing effect of bupivacaine wound infiltration after lower abdominal operations. J West Afr Coll Surg 2011; 1(3):62 – 82
8. Iyere SS, Bavishi H, Venkataran M, Kaur N. Comparison of epidural analgesia with transversus abdominis plane analgesia for postoperative pain relief in patients undergoing lower abdominal surgery; A prospective randomized study. Anesth Essays Res. 2017; 11(3):670-675
9. McDonnell JG, O'Donnell B, Curley G, Heffernan A, Power C, Laffey JG. The analgesic efficacy of transversus abdominis plane block after abdominal surgery: a prospective randomized trial Anesth Analg 2007;104:193 - 197
10. Carney J, Finnerty O, Rauf J, Curley G, McDonnell GJ, Laffey GJ. Ipsi lateral transversus abdominis plane block provides effective analgesia after appendectomy in children: A randomized controlled trial.
Anesth Analg 2010; 111(4):998 – 1003.
11. Carney J, McDonnell GJ, Ochanna A, Bhinder R, Laffey GJ. The transversus abdominis plane block provides effective postoperative analgesia in patients undergoing total abdominal hysterectomy. Anesth Analg 2008; 107(6):2056 - 2060
12. Fung D. Measuring patient satisfactions with anaesthesia care: A review of current methodology. Anesth Analg 1998; 84(5):1089-1098.
Downloads
Published
Issue
Section
License
All articles published in the journal are licensed under a Creative Commons Attribution (CC BY) license(i.e CC Attribution-NonCommercial-ShareAlike 4.0), allowing others to share, distribute, and build upon the work, provided the original author(s) and source are properly cited. Authors retain the copyright of their work.
