The transversus abdominis plane block (TAP block) has effect to postoperative analgesia for cesarean section with spinal anesthesia but it was limited for cesarean section with general anesthesia. The hypothesis that this technique has effect to postoperative analgesia for cesarean section with general anesthesia and it could reduce 50% of total morphine consumption during 24 hours after surgery.
This is a randomized, controlled, no-blind clinical trial. The investigators selected 60 cases, who were cesarean section under general anesthesia, age from18 years, and American Society Anesthesiologists (ASA) classification was from II-III. The cases of acute fetal impairment, local anesthesia contraindication, tolerance opioids, liver failure, renal failure, and spinal anesthesia failure were excluded. All cases were randomized assigned two groups: the TAP block group (T group) and controlled group (C group). Each group has 30 cases. The TAP block was performed under the ultrasound guidance with 0.25% of ropivacaine 20 ml each side. The both groups was treated postoperative analgesia with intravenous morphine to patients controlled analgesia (PCA). The primary outcome was total morphine consumption during 24 hours after surgery. The secondary outcomes were the time of required the first dose of morphine, pain score, the complications of TAP block, the side effects of morphine, and satisfaction score of participants. Data was described and analyzed with SPSS 25.0. The sample size was calculated with the hypothesis that TAP block could reduce 50% of dose morphine during 24 hours after surgery, 80% of power, 10% of loss, and 0.05 of alpha error.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
60
TAP block was performed under guidance with 0.25% ropivacaine 20 ml each side.
Single dose was 1 mg. The locked time was 6 minutes. The limited dose was 40 mg/ 4 giờ.
Ropivacaine 0.25% 20 ml each side
THANG Nguyen Trong
Ho Chi Minh City, Vietnam
Total morphine consumption during 24 hours
Morphine was intravenous perfusion to participants during 24 hours with patients controlled analgesia (PCA).
Time frame: 24 hours
The time required the first of dose of morphine (hours)
The time was from the end of surgery to the participants required the first of dose of morphine with PCA.
Time frame: 24 hours
Pain score: VAS
Pain score was measured with visual analogue scale (VAS). VAS is from 0 to 10. The zero is complete non-pain and the ten is severe pain
Time frame: 24 hours
The rate of complications of TAP block
There were rate of systemic toxicity, puncture peritonea, and hematomae in abdominal wall
Time frame: 24 hours
The rate of side effect of morphine
There were rate of sedation, respiratory failure, nause and vomiting, pruritus
Time frame: 24 hours
The satisfaction of participants: Likert
It was evaluated with Linkert score. Likerk score is from 1 to 5: 1-strongly disagree, 2-disagree, 3-neither agree nor disagree, 4-agree, 5-strongly agree
Time frame: 24 hours
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