TITLE:
A Case Series of 12 Patients Receiving Bilateral Transverse Abdominis Plane Blocks after Cesarean Section
AUTHORS:
Dennis Feierman, Aden Bronstein, Miriam Flaum, Marc Dany, Mohit Garg, Piyush Gupta, Kalpana Tyagaraj
KEYWORDS:
Liposomal Bupivacaine, Exparel, TAP Block, Cesarean-Section
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.7 No.12,
December
28,
2017
ABSTRACT: Transverse abdominis Plane blocks (TAP) provide effective postoperative analgesia following surgical incisions of the lower and middle abdominal wall, including those associated with cesarean section. This study investigated the efficacy of liposomal bupivacaine diluted with 0.25% bupivacaine administered in bilateral TAP blocks for post-operative analgesia after Ce-sarean section preformed under neuraxial anesthesia. The patients who received the TAP blocks with liposomal bupivacaine had noticeably low pain scores of 1.0 ± 1.4, 1.4 ± 2.1, 1.7 ± 1.9, 1.9 ± 3.3 and 1.9 ± 2.3 at 6, 12, 24, 48 and 72 hours respectively. Only 3 patients used oxycodone (5 mg)/acetaminophen (325 mg) postoperative. One patient took two tables of oxycodone (5 mg)/acetamino-phen (325 mg) after 24 hours, a second patient used oxycodone (5 mg)/aceta-minophen (325 mg) after 72 hours and the third patient was transferred to the intensive care unit (ICU) since she developed postpartum cardiac complications, and was give oxycodone (5 mg)/acetaminophen (325 mg) despite having a 0 pain score. These results suggest that patients treated bilateral TAP blocks with a mixture of liposomal and regular bupivacaine will have low pain scores, high patient satisfaction and reduce the use of postoperative narcotics.