title: Transversus abdominis plane block for postoperative analgesia after cesarean delivery.
abstract: OBJECTIVE
  The transversus abdominis plane (TAP) block is the ultrasound-guided placement of a peripheral nerve block in the abdominal wall for pain control. Our objective was to compare postoperative adjunctive oral narcotic use in women who underwent cesarean delivery and received the TAP block vs. those who received neuraxial narcotics. We hypothesize a decrease in narcotic use in women who received the TAP block.
  
  
  METHODS
  Retrospective cohort study of women who received a TAP block for postoperative analgesia after cesarean compared to women who did not. The primary outcome was the total number of oral narcotic tablets administered between 24 and 48 h after surgery. An independent t-test and an analysis of covariance were employed to determine significant differences (P < 0.05) between the cohorts and to adjust for confounders.
  
  
  RESULTS
  The TAP block cohort utilized 30% less oral narcotic analgesia than the control cohort (3.8 ± 0.5 tablets, P < 0.001). After adjusting for confounders and the presence of antecedent labor, there remained a significant reduction in the total oral narcotic doses given to women who underwent a TAP block compared to other forms of analgesia.
  
  
  CONCLUSIONS
  The TAP block is associated with decreased oral narcotic usage 24-48 h following cesarean delivery.
authors.affiliation: Department of Obstetrics and Gynecology, Madigan Army Medical Center, Tacoma, WA 98431, USA. samit.a.patel@us.army.mil
authors.forename: Samit A
authors.initials: SA
authors.lastname: Patel
authors.forename: Jennifer
authors.initials: J
authors.lastname: Gotkin
authors.forename: Raywin
authors.initials: R
authors.lastname: Huang
authors.forename: Charles
authors.initials: C
authors.lastname: Darling
authors.forename: Jason A
authors.initials: JA
authors.lastname: Pates
authors.forename: Brad
authors.initials: B
authors.lastname: Dolinsky
mesh_terms: D000009:Abdominal Muscles / Q000187:drug effects / Q000294:innervation*; D000284:Administration, Oral; D000328:Adult; D016362:Analgesia, Obstetrical / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D002585:Cesarean Section / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008954:Models, Biological; D009294:Narcotics / Q000008:administration & dosage; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000188:drug therapy*; D011247:Pregnancy; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional
chemical_list: D000779:Anesthetics, Local; D009294:Narcotics