Comparison of Spinal Morphine and Transversus Abdominis Plane Block on Opioid Requirements After Caesarean Section: An Observational Study.

IF 1.5 Q3 ANESTHESIOLOGY

Local and Regional Anesthesia Pub Date : 2024-06-12 eCollection Date: 2024-01-01 DOI:10.2147/LRA.S459530

Suwarman, Osmond Muftilov Pison, Mohammad Fikry Maulana, Prapanca Nugraha

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Abstract

Objective: Acute postoperative pain is one of the major clinical problems that occurs in patients undergoing cesarean section with a prevalence of 89.8%. Postoperative pain causes discomfort and various complications for the mother. In addition, postoperative pain that is not handled properly can increase the risk of becoming chronic pain by 2.5 times. One of the methods recommended in the Enhanced Recovery After Caesarean Section (ERACS) protocol to prevent acute postoperative pain is the use of intrathecal long-acting opioids, with intrathecal morphine as the gold standard and Transversus Abdominis Plane (TAP) block. This study aims to assess the comparison of opioid needs as analgesic rescue between the administration of 0.1mg spinal morphine and TAP block with bupivacaine 0.2% 10mg in patients undergoing cesarean section.

Methods: This study is an observational study in a single Tertiary Hospital in West Java - Indonesia. Patients were given patient-controlled anesthesia (PCA) with fentanyl as analgesic rescue. Statistical analysis of the numerical data used the unpaired t-test and Chi-Square test for categorical data.

Results: In the group that was given spinal morphine, the duration of additional opioids was longer (p < 0.05), and the total dose of additional opioids was less than the TAP block group (p < 0.05).

Conclusion: The spinal morphine requires fewer additional opioids than the TAP block.

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脊髓吗啡与腹横肌平面阻滞对剖腹产后阿片类药物需求的影响比较：一项观察性研究。

目的：急性术后疼痛是剖腹产患者的主要临床问题之一，发生率高达 89.8%。术后疼痛会给产妇带来不适和各种并发症。此外，术后疼痛如果处理不当，变成慢性疼痛的风险会增加 2.5 倍。增强剖腹产术后恢复（ERACS）方案中推荐的预防术后急性疼痛的方法之一是使用鞘内长效阿片类药物，其中鞘内吗啡是金标准，另外还有腹横肌平面（TAP）阻滞。本研究旨在评估剖宫产手术患者在使用 0.1 毫克脊髓吗啡和使用 0.2% 10 毫克布比卡因进行 TAP 阻滞时阿片类药物镇痛需求的比较：本研究是在印度尼西亚西爪哇的一家三级甲等医院进行的观察性研究。患者接受患者自控麻醉（PCA），并使用芬太尼镇痛。数字数据的统计分析采用非配对 t 检验，分类数据采用 Chi-Square 检验：结果：与 TAP 阻滞组相比，给予脊髓吗啡组的额外阿片类药物持续时间更长（P < 0.05），额外阿片类药物的总剂量更少（P < 0.05）：结论：与TAP阻滞相比，脊髓吗啡所需的额外阿片类药物更少。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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