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Dergiler / Bağcılar Tıp Bülteni / 2021 / Cilt: 6 - Sayı: 2

Transverse Abdominis Plane Block-based Multimodal Analgesia Protocol Reduces Tramadol Need After Cesarean Section

Transvers Abdominis Plan Bloğu Tabanlı Multimodal Analjezi Protokolü, Sezaryen Sonrası Tramadol İhtiyacını Azaltır

Savaş ÇÖMLEK
Sayfa
134–141
DOI
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Yapay Zeka Hızlı Bakış & Çıkarımlar

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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Multimodal analgesia including transverse abdominis plane block distinguishes itself with its most marked opioidsparing effect, while paracetamol does not appear to provide additional benefits.

📌 3 Maddede Bu Makale

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Amaç & Hipotez:Objective: Various strategies of multimodal analgesia exist for pain control following caesarean section, aiming to improve analgesia, reduce opioid requirement, and therefore decrease the incidence of opioid related side effects.
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Temel Bulgular & Veri:This study aimed to compare the analgesic quality and reduction in tramadol need across four different multimodal analgesia strategies after caesarean section with general anesthesia.Method: A total of 160 patients that underwent elective cesarean section under general anesthesia were retrospectively included in one of the following groups: only tramadol-based patient-controlled analgesia, tramadol-based patient-controlled analgesia plus diclofenac suppository, tramadol-based patient-controlled analgesia plus diclofenac suppository plus paracetamol, and tramadol-based patient-controlled analgesia plus diclofenac plus transverse abdominis plane block.
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Sonuç & Katkı:Multimodal analgesia including transverse abdominis plane block distinguishes itself with its most marked opioidsparing effect, while paracetamol does not appear to provide additional benefits.
🔬Tür:Araştırma Makalesi
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Alan Parametreleri

Özet

Objective: Various strategies of multimodal analgesia exist for pain control following caesarean section, aiming to improve analgesia, reduce opioid requirement, and therefore decrease the incidence of opioid related side effects. This study aimed to compare the analgesic quality and reduction in tramadol need across four different multimodal analgesia strategies after caesarean section with general anesthesia.Method: A total of 160 patients that underwent elective cesarean section under general anesthesia were retrospectively included in one of the following groups: only tramadol-based patient-controlled analgesia, tramadol-based patient-controlled analgesia plus diclofenac suppository, tramadol-based patient-controlled analgesia plus diclofenac suppository plus paracetamol, and tramadol-based patient-controlled analgesia plus diclofenac plus transverse abdominis plane block. Visual analogue scale scores and tramadol use were monitored and recorded at 2nd, 4th, 8th, 12th, and 24th hours. Results: At 2nd, 4th and 8th hours, tramadol-based patient-controlled analgesia-only group had significantly higher visual analogue scale scores than all other groups (p 0.05).Conclusion: Tramadol-based patient-controlled analgesia alone does not seem to provide effective pain control following caesarean section under general anesthesia. Multimodal analgesia including transverse abdominis plane block distinguishes itself with its most marked opioidsparing effect, while paracetamol does not appear to provide additional benefits.

Abstract

Amaç: Sezaryen sonrası postoperatif ağrı tedavisinde, opioid ihtiyacını azaltmayı ve dolayısıyla opioidle ilişkili yan etkilerin insidansını azaltmayı amaçlayan çeşitli multimodal analjezi stratejileri mevcuttur. Bu çalışma, genel anestezi ile sezaryen olan hastalarda uygulanan dört farklı multimodal analjezi stratejisinde, tramadol ihtiyacındaki azalmayı ve analjezi kalitesini karşılaştırmayı amaçladı. Yöntem: Genel anestezi altında elektif sezaryen yapılan toplam 160 hasta geriye dönük olarak şu gruplardan birine dahil edildi: sadece tramadol bazlı hasta kontrollü analjezi, tramadol bazlı hasta kontrollü analjezi artı diklofenak fitil, tramadol bazlı hasta- kontrollü analjezi artı diklofenak fitil artı parasetamol ve tramadol bazlı hasta kontrollü analjezi artı diklofenak artı transversus abdominis plan bloğu. Görsel analog skala skorları ve tramadol kullanımı 2., 4., 8., 12. ve 24. saatlerde izlenerek kaydedildi. Bulgular: İkinci, 4. ve 8. saatlerde, sadece tramadol kullanılan hasta kontrollü analjezi grubu diğer tüm gruplardan anlamlı olarak daha yüksek görsel analog skala puanlarına sahipti (p 0,05). Sonuç: Tramadol bazlı hasta kontrollü analjezi tek başına genel anestezi altında sezaryen sonrası etkili ağrı kontrolü sağlamamaktadır. Transversus abdominis plan bloğu tabanlı multimodal analjezi protokolü, en belirgin opioid koruyucu etkiye sahipken, parasetamol ek fayda sağlamıyor gibi görünmektedir.

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Bu Makaleye Atıf Yap

ÇÖMLEK, S. (2021). Transverse Abdominis Plane Block-based Multimodal Analgesia Protocol Reduces Tramadol Need After Cesarean Section. Bağcılar Tıp Bülteni, Cilt: 6 - Sayı: 2, 134–141. https://ajindex.com/articles/351093

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Kaynakça (12)

  1. Lavoie A, Toledo P. Multimodal postcesarean delivery analgesia. Clin Perinatol 2013;40(3):443-455
  2. Harrison DM, Sinatra R, Morgese L, Chung JH. Epidural narcotic and patient-controlled analgesia for post-cesarean section pain relief. Anesthesiology 1988;68(3):454-457
  3. Sharma SK, Sidawi JE, Ramin SM, Lucas MJ, Leveno KJ, Cunningham FG. Cesarean delivery: a randomized trial of epidural versus patient-controlled meperidine analgesia during labor. Anesthesiology 1997;87(3):487-494
  4. Fieni S, Angeri F, Kaihura CT, Ricci L, Bedocchi L, Galanti B, et al. [Evaluation of the peripartum effects of 2 analgesics: meperidine and tramadol, used in labor]. Acta Biomed Ateneo Parmense 2000;71(Suppl 1):397-400
  5. Demirel I, Ozer AB, Atilgan R, Kavak BS, Unlu S, Bayar MK, et al. Comparison of patient-controlled analgesia versus continuous infusion of tramadol in post-cesarean section pain management. J Obstet Gynaecol Res 2014;40(2):392-398
  6. Vadivelu N, Chang D, Helander EM, Bordelon GJ, Kai A, Kaye AD, et al. Ketorolac, oxymorphone, tapentadol, and tramadol: a comprehensive review. Anesthesiol Clin 2017;35(2):e1-e20. doi: 10.1016/j.anclin.2017.01.001
  7. Elia N, Lysakowski C, Tramer MR. Does multimodal analgesia with acetaminophen, nonsteroidal antiinflammatory drugs, or selective cyclooxygenase-2 inhibitors and patient-controlled analgesia morphine offer advantages over morphine alone? Meta-analyses of randomized trials. Anesthesiology 2005;103(6):1296-1304
  8. Siddik SM, Aouad MT, Jalbout MI, Rizk LB, Kamar GH, Baraka AS. Diclofenac and/or propacetamol for postoperative pain management after cesarean delivery in patients receiving patient controlled analgesia morphine. Reg Anesth Pain Med 2001;26(4):310-315
  9. Olofsson CI, Legeby MH, Nygards EB, Ostman KM. Diclofenac in the treatment of pain after caesarean delivery. An opioid-saving strategy. Eur J Obstet Gynecol Reprod Biol 2000;88(2):143-146
  10. Varrassi G, Marinangeli F, Agro F, Aloe L, De Cillis P, De Nicola A, et al. A double-blinded evaluation of propacetamol versus ketorolac in combination with patient-controlled analgesia morphine: analgesic efficacy and tolerability after gynecologic surgery. Anesth Analg 1999;88(3):611-616
  11. Mishriky BM, George RB, Habib AS. Transversus abdominis plane block for analgesia after Cesarean delivery: a systematic review and meta-analysis. Can J Anaesth 2012;59(8):766-778
  12. Eisenach JC, Grice SC, Dewan DM. Patient-controlled analgesia following cesarean secti