Sánchez-Palomo JJ, Esteban-Pizarro N, Calle-Elguezabal P, Gómez-Martínez AM, Brogly N, Santé-Serna L

Language: Spanish
References: 13
Page: 164-168
PDF size: 268.50 Kb.

ABSTRACT

Introduction: there are few studies about fast track protocols in caesarean sections. They recommend peripheral nerve blocks for pain control. Cesarean section causes severe pain. There are analgesic techniques in the literature, but few studies compare them. Material and methods: 84 patients scheduled for cesarean section were randomized for a triple-blind clinical trial in three parallel groups (TAP, morphine and control). Hypothesis: TAP (transverse abdominal plane) block is not inferiority than epidural morphine. Primary outcome: pain after 24 hours. Results: pain mean at 24 hours and its standard deviation of the TAP group is 2.86 and 2.01 respectively, while in the morphine group it is 2.9 and 1.88. The mean difference between TAP and morphine is -0.04 (95%CI -1.07; 0.99). Considering that the upper limit of the interval is lower than the established non-inferiority limit, the non-inferiority hypothesis is established. TAP group presented less pain at 6 hours (p = 0.037/95%CI -2.52; -0.08) and walking at discharge (p = 0.001/95%CI -2.36; -0.65), starts walking earlier (p = 0.04/95%CI -2.52; -0.08), causes fewer side effects and improves overall satisfaction than the morphine group. Conclusions: the TAP block is not inferior to 1 mg epidural morphine for pain control in cesarean sections.

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