Ultrasound Guided Transversus Abdominis Plane Block versus Intrathecal Nalbuphine Injection for Postoperative Analgesia in Preeclamptic Patients Undergoing Cesarean Section
Journal Title: Journal of Anesthesia and Surgery - Year 2018, Vol 5, Issue 1
Abstract
Introduction: Post-cesarean section effective analgesia is important, effective pain release helps in early mobilization and declines threat of thromboembolic diseases. The transversus abdominis plane (TAP) block is a regional analgesic procedure with a growing character in postoperative analgesia for lower abdominal surgeries. Nalbuphine, Intrathecal opioids has synergistic effect with local anesthetics and thereby exaggerate the sensory block without aggregate the sympathetic block. Patient and methods: 90 patients allocated as 30 patients in each group, all groups received intrathecal bupivacaine and TAP injection, group S had TAP injection with saline, Group B had TAP injection with bupivacaine, and group N had intrathecal nulbuphine and TAP injection with saline. Preoperative, at induction, intra and postoperative follow up of heart rate, systolic and diastolic blood pressure, total analgesic requirement (nalbuphine) in 24 hours, total I.V glyceraltrinitrate consumption in 24h, motor recovery, analgesic duration, Visual Analog Score (VAS) and effective analgesia time. Results: as regards analgesic duration and effective analgesia time, a significant increase in group N in comparison with group S and group B, also in group B compared with group S, while a significant decline in total analgesic dose in group N compared with other groups and by comparing group B with group S. Conclusion: Intrathecal nulbuphine and TAP block produce a significant prolongation in postoperative analgesic time and decrease postoperative analgesic consumption. However intrathecal nulbuphine showed significant advantages over TAP block.
Authors and Affiliations
Josef Attia
Development of a Fast-Track Protocol for Hydrocele Surgery
Objectives: To describe a multimodal recovery protocol (fast-track surgery) for hydrocele surgery, as developed by our urology department over the course of the last 10 years. Likewise, our aim was to demonstrate the use...
Ketamine-Propofol (Ketofol) as a Viable Alternative in a Septic Patient with Mediastinal Mass Requiring General Anesthesia for Endoscopic Retrograde Cholangio-Pancreatography
Airway compromise and cardiovascular collapse can be anticipated in a patient with mediastinal mass due to aneurysm of ascending and arch of aorta during any stage of anesthesia Presence of septic shock limits the use o...
Comparision of Taylor’s Approach Vs Lumbar Approach for Below Unbilicus Surgeries in Cases of Patients with Deformed Spines
Background and Aim: The paramedian technique was popular in patients with abnormal anatomy. Taylor modified the paramedian technique (Taylor’s approach) which is reliable and less traumatic alternative in deformed spine...
Discovering What Patients Really Expect from Their Anesthesiologist
As twenty-first century medicine shifts from a production-based model to a patient-centered model and as the emphasis on quality and patient satisfaction increases anesthesiologists will need to pay special attention t...
Perioperative Pregabalin for Postoperative Pain Relief after Thoracotomy
Background: Pregabalin is effective both at controlling postoperative pain and preventing chronic neuropathic pain. Local anaesthetic infiltration is a simple and inexpensive method to provide postoperative analgesia. In...