PMID- 30573987
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220330
IS  - 1178-7090 (Print)
IS  - 1178-7090 (Electronic)
IS  - 1178-7090 (Linking)
VI  - 11
DP  - 2018
TI  - Transversus abdominis plane block with liposomal bupivacaine for pain control 
      after cesarean delivery: a retrospective chart review.
PG  - 3109-3116
LID - 10.2147/JPR.S184279 [doi]
AB  - BACKGROUND: Adverse effects of opioid analgesics and potential for chronic use 
      are limitations in the cesarean setting. Regional anesthesia using transversus 
      abdominis plane (TAP) block post-cesarean delivery may improve analgesia and 
      reduce opioid consumption. Effectiveness of TAP block using liposomal bupivacaine 
      (LB) to reduce post-cesarean pain is unknown. METHODS: We performed a 
      single-center retrospective chart review of patients aged >/=18 years who underwent 
      cesarean delivery with a multimodal pain management protocol with or without TAP 
      block with LB 266 mg. Assessments included postsurgical opioid consumption; area 
      under the curve (AUC) of numeric rating scale pain scores from 0 to 3 days; 
      proportion of opioid-free patients; discharge- and post-anesthesia care unit 
      (PACU)-ready time; times to ambulation, solid food, and bowel movement; hospital 
      length of stay (LOS); and adverse events (AEs). Data were analyzed in the total 
      population and in first- and repeat-cesarean subgroups using Wilcoxon, 
      chi-squared, and Student's t-tests. RESULTS: Of 201 patients, 101 were treated 
      with LB TAP block (LB-TAPB) and 100 without LB-TAPB. Treatment with LB-TAPB vs 
      without LB-TAPB significantly reduced mean post-surgical opioid consumption 
      (total, 47%; first-cesarean, 54%; repeat-cesarean, 42%; P<0.001 each) and mean 
      AUC of pain scores (total, 46%; first-cesarean, 57%; repeat-cesarean, 40%; 
      P<0.001 each). Patients treated with LB-TAPB had significantly shorter mean 
      discharge-ready times (2.9 vs 3.6 days; P=0.006), PACU-ready times (138 vs 163 
      minutes; P=0.028), and LOS (2.9 vs 3.9 days; P<0.001). LB-TAPB significantly 
      decreased mean times to ambulation and solid food by 39% and 31% (P<0.01 each), 
      respectively, and numerically reduced mean time to bowel movement (26%; P=0.05). 
      Fewer patients treated with LB-TAPB vs without LB-TAPB reported an AE (34% vs 
      50%; P=0.026). CONCLUSION: These results suggest multimodal pain management 
      incorporating TAP block with LB 266 mg is an effective approach to reducing 
      opioid requirements and improving analgesia post-cesarean delivery.
FAU - Baker, B Wycke
AU  - Baker BW
AD  - Department of Obstetrical and Gynecological Anesthesiology, Texas Children's 
      Hospital Pavilion for Women, Houston, TX, USA, bwbaker@texaschildrens.org.
AD  - US Anesthesia Partners, Houston, TX, USA, bwbaker@texaschildrens.org.
AD  - Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, 
      USA, bwbaker@texaschildrens.org.
AD  - Department of Anesthesiology, Baylor College of Medicine, Houston, TX, USA, 
      bwbaker@texaschildrens.org.
FAU - Villadiego, Lea G
AU  - Villadiego LG
AD  - Department of Obstetrical and Gynecological Anesthesiology, Texas Children's 
      Hospital Pavilion for Women, Houston, TX, USA, bwbaker@texaschildrens.org.
AD  - US Anesthesia Partners, Houston, TX, USA, bwbaker@texaschildrens.org.
FAU - Lake, Y Natasha
AU  - Lake YN
AD  - Department of Obstetrical and Gynecological Anesthesiology, Texas Children's 
      Hospital Pavilion for Women, Houston, TX, USA, bwbaker@texaschildrens.org.
AD  - US Anesthesia Partners, Houston, TX, USA, bwbaker@texaschildrens.org.
FAU - Amin, Yazan
AU  - Amin Y
AD  - Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, 
      USA, bwbaker@texaschildrens.org.
FAU - Timmins, Audra E
AU  - Timmins AE
AD  - Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, 
      USA, bwbaker@texaschildrens.org.
FAU - Swaim, Laurie S
AU  - Swaim LS
AD  - Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, 
      USA, bwbaker@texaschildrens.org.
FAU - Ashton, David W
AU  - Ashton DW
AD  - Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, 
      USA, bwbaker@texaschildrens.org.
LA  - eng
PT  - Journal Article
DEP - 20181210
PL  - New Zealand
TA  - J Pain Res
JT  - Journal of pain research
JID - 101540514
PMC - PMC6292394
OTO - NOTNLM
OT  - cesarean section
OT  - liposomal bupivacaine
OT  - postoperative pain management
OT  - transversus abdominis plane block
COIS- Disclosure BW Baker received research funding and consulting fees from Pacira 
      Pharmaceuticals, Inc. LG Villadiego received research funding from Pacira 
      Pharmaceuticals, Inc. The authors report no other conflicts of interest in this 
      work.
EDAT- 2018/12/24 06:00
MHDA- 2018/12/24 06:01
PMCR- 2018/12/10
CRDT- 2018/12/22 06:00
PHST- 2018/12/22 06:00 [entrez]
PHST- 2018/12/24 06:00 [pubmed]
PHST- 2018/12/24 06:01 [medline]
PHST- 2018/12/10 00:00 [pmc-release]
AID - jpr-11-3109 [pii]
AID - 10.2147/JPR.S184279 [doi]
PST - epublish
SO  - J Pain Res. 2018 Dec 10;11:3109-3116. doi: 10.2147/JPR.S184279. eCollection 2018.