naa a22 4500 510743692 CHVBK 20180411083037.0 cr unu---uuuuu 180411e20130301xx s 000 0 eng 10.1007/s12630-012-9866-6 doi (NATIONALLICENCE)springer-10.1007/s12630-012-9866-6 Transversus abdominis plane blocks for rescue analgesia following Cesarean delivery: a case series [Elektronische Daten] [Farheen Mirza, Brendan Carvalho] Le bloc dans le plan du muscle transverse de l'abdomen pour l'analgésie de secours après un accouchement par césarienne: une série de cas Purpose: The role of routine transversus abdominis plane (TAP) blocks at the time of surgery for Cesarean delivery analgesia is uncertain. Previous studies have shown no additional analgesic benefit in patients receiving intrathecal morphine. We present a series of three cases where TAP blocks were used for rescue analgesia in patients who had severe post-Cesarean delivery pain after a standard spinal anesthetic containing bupivacaine 12mg, fentanyl 10μg, and morphine 200μg. Clinical features: All three women experienced severe incisional pain in the postanesthetic care unit (PACU) after offset of spinal anesthesia. When the pain did not subside with intravenous opioids, the women were offered either additional intravenous opioids or a TAP block. They chose the latter. Bilateral TAP blocks were performed in a sterile posterior approach under ultrasound guidance with 0.375% ropivacaine 20mL with epinephrine 1:400,000. All three patients experienced significant pain relief that lasted 10-19 hr and allowed for a timely discharge from the PACU. Conclusion: These cases show that TAP blocks may play a valuable role as a rescue analgesic technique rather than as a routine preemptive block for all Cesarean delivery patients. Use of TAP blocks reduced the need for escalating intravenous opioid doses and potential maternal opioid-related side effects. Rescue TAP blocks should be considered after Cesarean delivery when intrathecal morphine does not provide adequate pain relief or for early breakthrough pain after offset of spinal anesthesia. Canadian Anesthesiologists' Society, 2012 Mirza Farheen Department of Anesthesia, Stanford University School of Medicine, 300 Pasteur Drive, 94305, Stanford, CA, USA aut Carvalho Brendan Department of Anesthesia, Stanford University School of Medicine, 300 Pasteur Drive, 94305, Stanford, CA, USA aut Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/3(2013-03-01), 299-303 0832-610X 60:3<299 2013 60 12630 https://doi.org/10.1007/s12630-012-9866-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12630-012-9866-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Mirza Farheen Department of Anesthesia, Stanford University School of Medicine, 300 Pasteur Drive, 94305, Stanford, CA, USA aut NATIONALLICENCE 700 1- Carvalho Brendan Department of Anesthesia, Stanford University School of Medicine, 300 Pasteur Drive, 94305, Stanford, CA, USA aut NATIONALLICENCE 773 0- Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/3(2013-03-01), 299-303 0832-610X 60:3<299 2013 60 12630 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer