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A Randomized Trial Comparing Surgeon-administered Intraoperative Transversus Abdominis Plane Block With Anesthesiologist-administered Transcutaneous Block

Narasimhulu, D.M.; Scharfman, L.; Minkoff, H.; George, B.; Homel, P.; Tyagaraj, K.

doi: 10.1097/01.aoa.0000557697.08495.90
Anesthesia and Analgesia: Postoperative Analgesia
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(Int J Obstet Anesth. 2018;35:26–32)

Traditionally, transversus abdominis plane (TAP) blocks are performed percutaneously by anesthesiologists using ultrasound guidance to prevent damage to intra-abdominal structures or injection into the incorrect plane. However, ultrasound-guided blocks pose potential problems, particularly in obese patients or patients with poor muscular tone, where visualization may be difficult. There have been reports of puncturing intraperitoneal structures during the performance of these blocks. In addition, ultrasound-guided blocks may be time consuming. An alternative to this method is surgeon-administered intraoperative TAP blocks, which eliminate the risk of intraperitoneal injury since they are performed under direct visualization. This study aimed to compare surgical TAP blocks with conventional TAP blocks in patients undergoing cesarean delivery.

Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, NY

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