Effects of Ultrasonography-Guided Transversus Abdominis Plane Block on Postoperative Analgesia, Gastrointestinal Motility, and Mobilization in Patients Delivering Cesarean Delivery Under Spinal Anesthesia: A Retrospective Study

Abstract

Aim: The aim of this study was to investigate the effect of ultrasonography (USG)-guided transversus abdominis plane (TAP) block on postoperative analgesia, gastrointestinal motility, and mobilization time in patients who had a cesarean section under spinal anesthesia. Material and Methods: The follow-up forms of the total 81 patients who had elective cesarean delivery under spinal anesthesia between March 2022 and June 2022 were reviewed retrospectively. The patients were divided into two groups, 41 patients as the TAP block applied group (group T) and 40 patients as the control group (group C). Demographic data of patients, visual analog scale (VAS) values at postoperative 2nd-, 4th-, 6th-, 12th-, and 24th-hour, tramadol requirements, non-steroidal anti-inflammatory drug (NSAID) and tramadol consumption, postoperative nausea-vomiting (PONV) status, initial gas release times and mobilization times were analyzed. Results: The VAS scores of the patients in group T at the postoperative period 2nd-, 4th-, and 6th-hour were significantly lower than those of group C (p<0.001). However, the rate of PONV (p=0.006), tramadol requirement (p=0.002), amount of tramadol (p=0.003) and NSAID consumed (p<0.001), and mobilization time (p=0.005) were significantly lower in patients in group T. The time until the passage of flatus was short in Group T, although it was not significant (p=0.072). Conclusion: The USG-guided TAP block significantly contributes to multimodal analgesia after cesarean delivery and may contribute to the early mobilization of patients and the return of gastrointestinal functions.

Keywords

• obstetrical analgesia
• postoperative pain
• TAP block
• cesarean section
• early ambulation
• gastrointestinal motility

Spinal Anestezi Altında Sezaryen Doğum Gerçekleştiren Hastalarda Ultrasonografi Kılavuzluğunda Uygulanan Transversus Abdominis Plan Bloğun Postoperatif Analjezi, Gastrointestinal Motilite ve Mobilizasyon Zamanına Etkisi: Retrospektif Çalışma

Abstract

Amaç: Bu çalışmanın amacı, spinal anestezi altında sezaryen doğum yapan hastalarda ultrasonografi (USG) kılavuzluğunda uygulanan transversus abdominis plan (TAP) bloğun postoperatif analjezi, gastrointestinal motilite ve mobilizasyon zamanına etkisini araştırmaktır. Gereç ve Yöntemler: Mart 2022 ile Haziran 2022 tarihleri arasında spinal anestezi altında elektif sezaryen doğum gerçekleştirmiş olan toplam 81 hastanın takip dosyaları geriye dönük olarak incelendi. Hastalar, 41 hasta TAP blok uygulanan grup (grup T) ve 40 hasta kontrol grubu (grup K) olmak üzere iki gruba ayrıldı. Hastaların demografik verileri, postoperatif dönem 2., 4., 6., 12. ve 24. saatlerdeki vizüel analog skala (VAS) değerleri, tramadol gereksinimleri, non-steroid anti inflamatuar ilaç (NSAİİ) ve tramadol tüketimleri, postoperatif bulantı-kusma (postoperative nausea-vomiting, PONV) durumları, ilk gaz çıkış zamanları ile mobilizasyon zamanları analiz edildi. Bulgular: Grup T’deki hastaların postoperatif 2., 4. ve 6. saatlerdeki VAS skorları grup K’ye göre anlamlı olarak daha düşüktü (p<0,001). Bununla birlikte grup T’deki hastalarda PONV görülme oranı (p=0,006), tramadol gereksinimi (p=0,002), tüketilen tramadol (p=0,003) ve NSAİİ (p<0,001) miktarı ile mobilizasyon süresi (p=0,005) anlamlı olarak düşük saptandı. Grup T'de ilk gaz çıkışına kadar geçen süre kısa olmakla birlikte anlamlı değildi (p=0,072). Sonuç: USG kılavuzluğunda uygulanan TAP bloğun sezaryen doğum sonrası multimodal analjeziye önemli katkı sağladığını ve hastaların erken mobilizasyonuna ve gastrointestinal fonksiyonların geri dönüşüne katkı sağlayabileceğini düşünüyoruz.

Keywords

• obstetrik analjezi
• postoperatif ağrı
• TAP blok
• sezaryen doğum
• erken ambulasyon
• gastrointestinal motilite

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