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Anterior approach of abdominal field block at linea semilunaris: A surgically assisted novel technique for postoperative analgesia in cesarean section

CONTEXT: Post Caesarean pain is described as moderate to severe. Although advances in the new analgesics techniques, no current standard exists for optimizing and managing. Taking into consideration of acute post Caesarean pain, this novel technique of surgically assisted anterior abdominal field bl...

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Autores principales: Akhade, Geetanjali R., Dangat, Vaibhav H., Bhalerao, Pradnya M., Darawade, Sameer P., Sale, H. K., Khond, Sandhya L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164471/
https://www.ncbi.nlm.nih.gov/pubmed/32317866
http://dx.doi.org/10.4103/sja.SJA_513_19
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author Akhade, Geetanjali R.
Dangat, Vaibhav H.
Bhalerao, Pradnya M.
Darawade, Sameer P.
Sale, H. K.
Khond, Sandhya L.
author_facet Akhade, Geetanjali R.
Dangat, Vaibhav H.
Bhalerao, Pradnya M.
Darawade, Sameer P.
Sale, H. K.
Khond, Sandhya L.
author_sort Akhade, Geetanjali R.
collection PubMed
description CONTEXT: Post Caesarean pain is described as moderate to severe. Although advances in the new analgesics techniques, no current standard exists for optimizing and managing. Taking into consideration of acute post Caesarean pain, this novel technique of surgically assisted anterior abdominal field block at linea semilunaris have proved considerable analgesic potential along with multimodal analgesia. AIMS: Although advances have been made in the understanding of the pathophysiology and in the development of new analgesics, patients still suffer from moderate-to-severe post-Cesarean pain. Taking into consideration the consequences of pain, this anterior approach to abdominal field block technique was performed to minimize acute pain experienced during post-Cesarean section. SETTINGS AND DESIGN: Prospective observational study design. MATERIALS AND METHODS: In the present study, a total of 120 parturients undergoing cesarean section (CS), after closure of uterine incision were included. We intraoperatively, under all asepsis, performed surgically assisted abdominal field block at linea semilunaris, by bilaterally injecting 20 mL 0.25% bupivacaine on each side, in addition to standard analgesic 100 mg diclofenac suppository. Each patient was assessed at 0, 4, 8, 12, and 24 h after surgery, by an independent observer for pain using NRS 0–10 and the time of the first demand for analgesic diclofenac paracetamol and its side effects. STATISTICAL ANALYSIS USED: The entire data is statistically analyzed using Statistical Package for Social Sciences (SPSS ver. 21.0, IBM Corporation, USA) for MS Windows. The categorical variables were compared using Wilcoxon's signed-rank test. RESULTS: Of the total 120 patients, it is worth noting that none of the patients had severe or worst pain. The percentage of patients who did not require analgesia were (96.7%) at 4 h, (81.7%) at 8 h, (77.5%) at 12 h, and (90.8%) at 24 h. The mean analgesic consumption of paracetamol diclofenac on 4, 8, 12, 16, and 24 h after CS was significantly less. No patient required opioid supplementation. Patient satisfaction was high and was early ambulated. CONCLUSIONS: There is considerable potential for anterior approach abdominal field block, (linea semilunaris block) to comprise an effective component of a multimodal regimen for post-Cesarean section analgesia and is easy to perform within limited resources.
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spelling pubmed-71644712020-04-21 Anterior approach of abdominal field block at linea semilunaris: A surgically assisted novel technique for postoperative analgesia in cesarean section Akhade, Geetanjali R. Dangat, Vaibhav H. Bhalerao, Pradnya M. Darawade, Sameer P. Sale, H. K. Khond, Sandhya L. Saudi J Anaesth Original Article CONTEXT: Post Caesarean pain is described as moderate to severe. Although advances in the new analgesics techniques, no current standard exists for optimizing and managing. Taking into consideration of acute post Caesarean pain, this novel technique of surgically assisted anterior abdominal field block at linea semilunaris have proved considerable analgesic potential along with multimodal analgesia. AIMS: Although advances have been made in the understanding of the pathophysiology and in the development of new analgesics, patients still suffer from moderate-to-severe post-Cesarean pain. Taking into consideration the consequences of pain, this anterior approach to abdominal field block technique was performed to minimize acute pain experienced during post-Cesarean section. SETTINGS AND DESIGN: Prospective observational study design. MATERIALS AND METHODS: In the present study, a total of 120 parturients undergoing cesarean section (CS), after closure of uterine incision were included. We intraoperatively, under all asepsis, performed surgically assisted abdominal field block at linea semilunaris, by bilaterally injecting 20 mL 0.25% bupivacaine on each side, in addition to standard analgesic 100 mg diclofenac suppository. Each patient was assessed at 0, 4, 8, 12, and 24 h after surgery, by an independent observer for pain using NRS 0–10 and the time of the first demand for analgesic diclofenac paracetamol and its side effects. STATISTICAL ANALYSIS USED: The entire data is statistically analyzed using Statistical Package for Social Sciences (SPSS ver. 21.0, IBM Corporation, USA) for MS Windows. The categorical variables were compared using Wilcoxon's signed-rank test. RESULTS: Of the total 120 patients, it is worth noting that none of the patients had severe or worst pain. The percentage of patients who did not require analgesia were (96.7%) at 4 h, (81.7%) at 8 h, (77.5%) at 12 h, and (90.8%) at 24 h. The mean analgesic consumption of paracetamol diclofenac on 4, 8, 12, 16, and 24 h after CS was significantly less. No patient required opioid supplementation. Patient satisfaction was high and was early ambulated. CONCLUSIONS: There is considerable potential for anterior approach abdominal field block, (linea semilunaris block) to comprise an effective component of a multimodal regimen for post-Cesarean section analgesia and is easy to perform within limited resources. Wolters Kluwer - Medknow 2020 2020-03-05 /pmc/articles/PMC7164471/ /pubmed/32317866 http://dx.doi.org/10.4103/sja.SJA_513_19 Text en Copyright: © 2020 Saudi Journal of Anesthesia http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Akhade, Geetanjali R.
Dangat, Vaibhav H.
Bhalerao, Pradnya M.
Darawade, Sameer P.
Sale, H. K.
Khond, Sandhya L.
Anterior approach of abdominal field block at linea semilunaris: A surgically assisted novel technique for postoperative analgesia in cesarean section
title Anterior approach of abdominal field block at linea semilunaris: A surgically assisted novel technique for postoperative analgesia in cesarean section
title_full Anterior approach of abdominal field block at linea semilunaris: A surgically assisted novel technique for postoperative analgesia in cesarean section
title_fullStr Anterior approach of abdominal field block at linea semilunaris: A surgically assisted novel technique for postoperative analgesia in cesarean section
title_full_unstemmed Anterior approach of abdominal field block at linea semilunaris: A surgically assisted novel technique for postoperative analgesia in cesarean section
title_short Anterior approach of abdominal field block at linea semilunaris: A surgically assisted novel technique for postoperative analgesia in cesarean section
title_sort anterior approach of abdominal field block at linea semilunaris: a surgically assisted novel technique for postoperative analgesia in cesarean section
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164471/
https://www.ncbi.nlm.nih.gov/pubmed/32317866
http://dx.doi.org/10.4103/sja.SJA_513_19
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