Article ; Online: The use of bilateral transversus abdominis plane blocks with liposomal bupivacaine on postoperative cesarean delivery patients during COVID-19 pandemic is associated with reduced narcotics use and reduced length of stay.
Women's health (London, England)
2021 Volume 17, Page(s) 17455065211058046
Abstract: Background: The use of transversus abdominis plane blocks has been previously shown in both large-scale studies and our own institution to significantly reduce postoperative pain and opioid use. In addition, the use of bilateral transversus abdominis ... ...
| Abstract | Background: The use of transversus abdominis plane blocks has been previously shown in both large-scale studies and our own institution to significantly reduce postoperative pain and opioid use. In addition, the use of bilateral transversus abdominis plane blocks using liposomal bupivacaine in combination with neuraxial morphine significantly reduced post-cesarean-delivery pain and opioid use. During the COVID-19 crisis, our anesthesia department in a collaborative effort with our obstetric colleagues thought that the use of bilateral transversus abdominis plane blocks with liposomal bupivacaine could reduce the use of opioids to treat postoperative pain and might result in decreased length of stay. Methods: After institutional review board approval, a retrospective study of 288 patients who underwent cesarean delivery under spinal or epidural (neuraxial) anesthesia at Maimonides Medical Center in Brooklyn, NY was conducted. Historical controls were from 142 consecutive patients from 1 January 2012 through 12 May 2012. An additional set of controls consisted of 30 consecutive patients from 10 March 2020 through 13 April 2020. The primary outcome data analyzed were the use of opioids and length of stay. Results: Post cesarean delivery, patients who received both bilateral transversus abdominis plane blocks with liposomal bupivacaine and neuraxial morphine was associated with a significant decrease in the number of patients using post operative opioids, 54%-60% decreased to 18% ( Conclusion: Neuraxial opioids combined with liposomal bupivacaine transversus abdominis plane blocks provided significant pain relief for patients post cesarean delivery, required less post operative opioids, and facilitated earlier discharge that may aid in reducing patient exposure and hospital burden secondary to COVID-19. |
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| MeSH term(s) | Abdominal Muscles ; Anesthetics, Local ; Bupivacaine ; COVID-19 ; Female ; Humans ; Length of Stay ; Narcotics ; Pandemics ; Pregnancy ; Retrospective Studies ; SARS-CoV-2 | |||||
| Chemical Substances | Anesthetics, Local ; Narcotics ; Bupivacaine (Y8335394RO) | |||||
| Language | English | |||||
| Publishing date | 2021-11-13 | |||||
| Publishing country | United States | |||||
| Document type | Journal Article | |||||
| ZDB-ID | 2274503-8 | |||||
| ISSN | 1745-5065 ; 1745-5057 | |||||
| ISSN (online) | 1745-5065 | |||||
| ISSN | 1745-5057 | |||||
| DOI | 10.1177/17455065211058046 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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