The addition of intrathecal morphine to a transversus abdominis plane block with liposome bupivacaine provides more effective analgesia than transversus abdominis plane block with liposome bupivacaine alone: a retrospective study

• Published in: Local and regional anesthesia 2019-01, Vol.12, p.7-13
• Main Authors: Hutchins, Jacob L, Renfro, Leslie, Orza, Florin, Honl, Cody, Navare, Sagar, Berg, Aaron A
• Format: Article
• Language: English
• Subjects: acute pain; Age; Analgesia; Analgesics; Anesthesia; Body mass index; Bupivacaine; Cesarean section; Clinical trials; Health risk assessment; Laparoscopy; Meta-analysis; Morphine; Narcotics; Nonsteroidal anti-inflammatory drugs; obstetric anesthesia; obstetric surgery; Obstetrics; Original Research; Pain; Patients; Pharmaceuticals; regional anesthesia; Research funding; Studies; Surgery; Systematic review; Ultrasonic imaging; Vomiting
• ISSN: 1178-7112; 1178-7112
• DOI: 10.2147/LRA.S190225

The purpose of this study was to determine if the standardization of using liposomal bupivacaine in transversus abdominis plane (LB TAP) blocks eliminated the benefit of intrathecal morphine (ITM) in patients after undergoing a cesarean section. This was a retrospective review of 358 patients who underwent cesarean section over an 11-month period. Patients were divided into two groups: those who received only an LB TAP (67 patients) vs those who received an LB TAP and ITM (291 patients). All blocks were placed bilaterally under ultrasound guidance after closure of the surgical incision, and morphine was added to the spinal used for the case. The group that received ITM in addition to the LB TAP received less opioids in the first 24 hours (median 5 range 0-150 mg morphine equivalents [ME] vs 15 range 0-76 mg ME;