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Transversus abdominis plane block with liposomal bupivacaine for pain control after cesarean delivery: a retrospective chart review
Adverse effects of opioid analgesics and potential for chronic use are limitations in the cesarean setting. Regional anesthesia using transversus abdominis plane (TAP) block post-cesarean delivery may improve analgesia and reduce opioid consumption. Effectiveness of TAP block using liposomal bupivac...
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| Published in: | Journal of pain research 2018-01, Vol.11, p.3109-3116 |
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| container_title | Journal of pain research |
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| creator | Baker, B Wycke Villadiego, Lea G Lake, Y Natasha Amin, Yazan Timmins, Audra E Swaim, Laurie S Ashton, David W |
| description | Adverse effects of opioid analgesics and potential for chronic use are limitations in the cesarean setting. Regional anesthesia using transversus abdominis plane (TAP) block post-cesarean delivery may improve analgesia and reduce opioid consumption. Effectiveness of TAP block using liposomal bupivacaine (LB) to reduce post-cesarean pain is unknown.
We performed a single-center retrospective chart review of patients aged ≥18 years who underwent cesarean delivery with a multimodal pain management protocol with or without TAP block with LB 266 mg. Assessments included postsurgical opioid consumption; area under the curve (AUC) of numeric rating scale pain scores from 0 to 3 days; proportion of opioid-free patients; discharge- and post-anesthesia care unit (PACU)-ready time; times to ambulation, solid food, and bowel movement; hospital length of stay (LOS); and adverse events (AEs). Data were analyzed in the total population and in first- and repeat-cesarean subgroups using Wilcoxon, chi-squared, and Student's
tests.
Of 201 patients, 101 were treated with LB TAP block (LB-TAPB) and 100 without LB-TAPB. Treatment with LB-TAPB vs without LB-TAPB significantly reduced mean post-surgical opioid consumption (total, 47%; first-cesarean, 54%; repeat-cesarean, 42%; |
| doi_str_mv | 10.2147/JPR.S184279 |
| format | article |
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We performed a single-center retrospective chart review of patients aged ≥18 years who underwent cesarean delivery with a multimodal pain management protocol with or without TAP block with LB 266 mg. Assessments included postsurgical opioid consumption; area under the curve (AUC) of numeric rating scale pain scores from 0 to 3 days; proportion of opioid-free patients; discharge- and post-anesthesia care unit (PACU)-ready time; times to ambulation, solid food, and bowel movement; hospital length of stay (LOS); and adverse events (AEs). Data were analyzed in the total population and in first- and repeat-cesarean subgroups using Wilcoxon, chi-squared, and Student's
tests.
Of 201 patients, 101 were treated with LB TAP block (LB-TAPB) and 100 without LB-TAPB. Treatment with LB-TAPB vs without LB-TAPB significantly reduced mean post-surgical opioid consumption (total, 47%; first-cesarean, 54%; repeat-cesarean, 42%;
<0.001 each) and mean AUC of pain scores (total, 46%; first-cesarean, 57%; repeat-cesarean, 40%;
<0.001 each). Patients treated with LB-TAPB had significantly shorter mean discharge-ready times (2.9 vs 3.6 days;
=0.006), PACU-ready times (138 vs 163 minutes;
=0.028), and LOS (2.9 vs 3.9 days;
<0.001). LB-TAPB significantly decreased mean times to ambulation and solid food by 39% and 31% (
<0.01 each), respectively, and numerically reduced mean time to bowel movement (26%;
=0.05). Fewer patients treated with LB-TAPB vs without LB-TAPB reported an AE (34% vs 50%;
=0.026).
These results suggest multimodal pain management incorporating TAP block with LB 266 mg is an effective approach to reducing opioid requirements and improving analgesia post-cesarean delivery.</description><identifier>ISSN: 1178-7090</identifier><identifier>EISSN: 1178-7090</identifier><identifier>DOI: 10.2147/JPR.S184279</identifier><identifier>PMID: 30573987</identifier><language>eng</language><publisher>New Zealand: Dove Medical Press Limited</publisher><subject>Aircraft ; Analgesia ; Analgesics ; Analysis ; Anesthesia ; Anesthesiology ; Bupivacaine ; Cesarean section ; Clinical trials ; Consumption data ; Disease control ; Drug dosages ; FDA approval ; Health risk assessment ; Hospitals ; Internet ; liposomal bupivacaine ; Nalbuphine ; Narcotics ; Opioids ; Original Research ; Pain management ; Patients ; Postoperative pain ; postoperative pain management ; Surgeons ; Surgery ; Systematic review ; transversus abdominis plane block ; Womens health</subject><ispartof>Journal of pain research, 2018-01, Vol.11, p.3109-3116</ispartof><rights>COPYRIGHT 2018 Dove Medical Press Limited</rights><rights>2018. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2018 Baker et al. This work is published and licensed by Dove Medical Press Limited 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c599t-9256890422f7a8d966cc6e59b2ddbe504634cd5b5fdd963bb33041eca53e134d3</citedby><orcidid>0000-0002-2486-2815</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2237752922/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2237752922?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,313,314,727,780,784,792,885,25753,27922,27924,27925,37012,37013,44590,53791,53793,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30573987$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Baker, B Wycke</creatorcontrib><creatorcontrib>Villadiego, Lea G</creatorcontrib><creatorcontrib>Lake, Y Natasha</creatorcontrib><creatorcontrib>Amin, Yazan</creatorcontrib><creatorcontrib>Timmins, Audra E</creatorcontrib><creatorcontrib>Swaim, Laurie S</creatorcontrib><creatorcontrib>Ashton, David W</creatorcontrib><title>Transversus abdominis plane block with liposomal bupivacaine for pain control after cesarean delivery: a retrospective chart review</title><title>Journal of pain research</title><addtitle>J Pain Res</addtitle><description>Adverse effects of opioid analgesics and potential for chronic use are limitations in the cesarean setting. Regional anesthesia using transversus abdominis plane (TAP) block post-cesarean delivery may improve analgesia and reduce opioid consumption. Effectiveness of TAP block using liposomal bupivacaine (LB) to reduce post-cesarean pain is unknown.
We performed a single-center retrospective chart review of patients aged ≥18 years who underwent cesarean delivery with a multimodal pain management protocol with or without TAP block with LB 266 mg. Assessments included postsurgical opioid consumption; area under the curve (AUC) of numeric rating scale pain scores from 0 to 3 days; proportion of opioid-free patients; discharge- and post-anesthesia care unit (PACU)-ready time; times to ambulation, solid food, and bowel movement; hospital length of stay (LOS); and adverse events (AEs). Data were analyzed in the total population and in first- and repeat-cesarean subgroups using Wilcoxon, chi-squared, and Student's
tests.
Of 201 patients, 101 were treated with LB TAP block (LB-TAPB) and 100 without LB-TAPB. Treatment with LB-TAPB vs without LB-TAPB significantly reduced mean post-surgical opioid consumption (total, 47%; first-cesarean, 54%; repeat-cesarean, 42%;
<0.001 each) and mean AUC of pain scores (total, 46%; first-cesarean, 57%; repeat-cesarean, 40%;
<0.001 each). Patients treated with LB-TAPB had significantly shorter mean discharge-ready times (2.9 vs 3.6 days;
=0.006), PACU-ready times (138 vs 163 minutes;
=0.028), and LOS (2.9 vs 3.9 days;
<0.001). LB-TAPB significantly decreased mean times to ambulation and solid food by 39% and 31% (
<0.01 each), respectively, and numerically reduced mean time to bowel movement (26%;
=0.05). Fewer patients treated with LB-TAPB vs without LB-TAPB reported an AE (34% vs 50%;
=0.026).
These results suggest multimodal pain management incorporating TAP block with LB 266 mg is an effective approach to reducing opioid requirements and improving analgesia post-cesarean delivery.</description><subject>Aircraft</subject><subject>Analgesia</subject><subject>Analgesics</subject><subject>Analysis</subject><subject>Anesthesia</subject><subject>Anesthesiology</subject><subject>Bupivacaine</subject><subject>Cesarean section</subject><subject>Clinical trials</subject><subject>Consumption data</subject><subject>Disease control</subject><subject>Drug dosages</subject><subject>FDA approval</subject><subject>Health risk assessment</subject><subject>Hospitals</subject><subject>Internet</subject><subject>liposomal bupivacaine</subject><subject>Nalbuphine</subject><subject>Narcotics</subject><subject>Opioids</subject><subject>Original Research</subject><subject>Pain management</subject><subject>Patients</subject><subject>Postoperative pain</subject><subject>postoperative pain management</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Systematic review</subject><subject>transversus abdominis plane block</subject><subject>Womens health</subject><issn>1178-7090</issn><issn>1178-7090</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptks2L1DAUwIso7oeevEtAEEFmzEfTNHsQlmXVlQVF13NIk3QmY9rUpJ1lz_7jvnHGdUYkh4SXX37Je3lF8YzgOSWlePPx85f5V1KXVMgHxTEhop4JLPHDvfVRcZLzCuOqppI8Lo4Y5oLJWhwXP2-S7vPapTxlpBsbO9_7jIage4eaEM13dOvHJQp-iDl2OqBmGvxaG-0BaGNCA6yQif2YYkC6HV1CxmWdnO6RdcGD--4MaZQcEHlwZoQQMkudRoitvbt9Ujxqdcju6W4-Lb69u7y5-DC7_vT-6uL8ema4lONMUl7VEpeUtkLXVlaVMZXjsqHWNo7jsmKlsbzhrYVN1jSM4ZI4ozlzhJWWnRZXW6-NeqWG5Dud7lTUXv0OxLRQ8ChvglPMUFDpuiJWlpxUUtScVbgtpTAa3gGut1vXMDWds8ZB_jocSA93er9Ui7hWFZWUyRIEr3aCFH9MLo-q89m4sCl8nLKiBJKuaYk3d734B13FKfVQKkUpE4KDkv6lFhoS8H0b4V6zkapzXjO6oQRQ8_9QMKzrPPyiaz3EDw683DuwdDqMyxzDNPrY50Pw9RY08M05ufa-GASrTaMqaFS1a1Sgn-_X757905nsFxWZ45M</recordid><startdate>20180101</startdate><enddate>20180101</enddate><creator>Baker, B Wycke</creator><creator>Villadiego, Lea G</creator><creator>Lake, Y Natasha</creator><creator>Amin, Yazan</creator><creator>Timmins, Audra E</creator><creator>Swaim, Laurie S</creator><creator>Ashton, David W</creator><general>Dove Medical Press Limited</general><general>Taylor & Francis Ltd</general><general>Dove Medical Press</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7XB</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-2486-2815</orcidid></search><sort><creationdate>20180101</creationdate><title>Transversus abdominis plane block with liposomal bupivacaine for pain control after cesarean delivery: a retrospective chart review</title><author>Baker, B Wycke ; Villadiego, Lea G ; Lake, Y Natasha ; Amin, Yazan ; Timmins, Audra E ; Swaim, Laurie S ; Ashton, David W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c599t-9256890422f7a8d966cc6e59b2ddbe504634cd5b5fdd963bb33041eca53e134d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aircraft</topic><topic>Analgesia</topic><topic>Analgesics</topic><topic>Analysis</topic><topic>Anesthesia</topic><topic>Anesthesiology</topic><topic>Bupivacaine</topic><topic>Cesarean section</topic><topic>Clinical trials</topic><topic>Consumption data</topic><topic>Disease control</topic><topic>Drug dosages</topic><topic>FDA approval</topic><topic>Health risk assessment</topic><topic>Hospitals</topic><topic>Internet</topic><topic>liposomal bupivacaine</topic><topic>Nalbuphine</topic><topic>Narcotics</topic><topic>Opioids</topic><topic>Original Research</topic><topic>Pain management</topic><topic>Patients</topic><topic>Postoperative pain</topic><topic>postoperative pain management</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Systematic review</topic><topic>transversus abdominis plane block</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Baker, B Wycke</creatorcontrib><creatorcontrib>Villadiego, Lea G</creatorcontrib><creatorcontrib>Lake, Y Natasha</creatorcontrib><creatorcontrib>Amin, Yazan</creatorcontrib><creatorcontrib>Timmins, Audra E</creatorcontrib><creatorcontrib>Swaim, Laurie S</creatorcontrib><creatorcontrib>Ashton, David W</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Research Library</collection><collection>Research Library (Corporate)</collection><collection>Publicly Available Content Database (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Journal of pain research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Baker, B Wycke</au><au>Villadiego, Lea G</au><au>Lake, Y Natasha</au><au>Amin, Yazan</au><au>Timmins, Audra E</au><au>Swaim, Laurie S</au><au>Ashton, David W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transversus abdominis plane block with liposomal bupivacaine for pain control after cesarean delivery: a retrospective chart review</atitle><jtitle>Journal of pain research</jtitle><addtitle>J Pain Res</addtitle><date>2018-01-01</date><risdate>2018</risdate><volume>11</volume><spage>3109</spage><epage>3116</epage><pages>3109-3116</pages><issn>1178-7090</issn><eissn>1178-7090</eissn><abstract>Adverse effects of opioid analgesics and potential for chronic use are limitations in the cesarean setting. Regional anesthesia using transversus abdominis plane (TAP) block post-cesarean delivery may improve analgesia and reduce opioid consumption. Effectiveness of TAP block using liposomal bupivacaine (LB) to reduce post-cesarean pain is unknown.
We performed a single-center retrospective chart review of patients aged ≥18 years who underwent cesarean delivery with a multimodal pain management protocol with or without TAP block with LB 266 mg. Assessments included postsurgical opioid consumption; area under the curve (AUC) of numeric rating scale pain scores from 0 to 3 days; proportion of opioid-free patients; discharge- and post-anesthesia care unit (PACU)-ready time; times to ambulation, solid food, and bowel movement; hospital length of stay (LOS); and adverse events (AEs). Data were analyzed in the total population and in first- and repeat-cesarean subgroups using Wilcoxon, chi-squared, and Student's
tests.
Of 201 patients, 101 were treated with LB TAP block (LB-TAPB) and 100 without LB-TAPB. Treatment with LB-TAPB vs without LB-TAPB significantly reduced mean post-surgical opioid consumption (total, 47%; first-cesarean, 54%; repeat-cesarean, 42%;
<0.001 each) and mean AUC of pain scores (total, 46%; first-cesarean, 57%; repeat-cesarean, 40%;
<0.001 each). Patients treated with LB-TAPB had significantly shorter mean discharge-ready times (2.9 vs 3.6 days;
=0.006), PACU-ready times (138 vs 163 minutes;
=0.028), and LOS (2.9 vs 3.9 days;
<0.001). LB-TAPB significantly decreased mean times to ambulation and solid food by 39% and 31% (
<0.01 each), respectively, and numerically reduced mean time to bowel movement (26%;
=0.05). Fewer patients treated with LB-TAPB vs without LB-TAPB reported an AE (34% vs 50%;
=0.026).
These results suggest multimodal pain management incorporating TAP block with LB 266 mg is an effective approach to reducing opioid requirements and improving analgesia post-cesarean delivery.</abstract><cop>New Zealand</cop><pub>Dove Medical Press Limited</pub><pmid>30573987</pmid><doi>10.2147/JPR.S184279</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-2486-2815</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of pain research, 2018-01, Vol.11, p.3109-3116 |
| issn | 1178-7090 1178-7090 |
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| subjects | Aircraft Analgesia Analgesics Analysis Anesthesia Anesthesiology Bupivacaine Cesarean section Clinical trials Consumption data Disease control Drug dosages FDA approval Health risk assessment Hospitals Internet liposomal bupivacaine Nalbuphine Narcotics Opioids Original Research Pain management Patients Postoperative pain postoperative pain management Surgeons Surgery Systematic review transversus abdominis plane block Womens health |
| title | Transversus abdominis plane block with liposomal bupivacaine for pain control after cesarean delivery: a retrospective chart review |
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