title: [Combined use of continuous epidural anesthesia nand transversus abdominis plane block for postoperative management of cesarean delivery in a patient whose previous cesarean deliveries were not properly controlled].
abstract: We report the successful combined use of continuous epidural anesthesia and transversus abdominis plane block for the management of postoperative pain following a cesarean delivery in a patient whose paralysis and pain were not well controlled after two previous cesarean deliveries. A 28-year-old female patient with no remarkable medical history was scheduled to undergo cesarean delivery at 38 weeks and 3 days of pregnancy. She had undergone cesarean deliveries twice previously, at 23 and 25 years of age. Both of these procedures were concluded using combined spinal-epidural anesthesia. However, in both procedures, the continuous epidural catheter could not be removed within 12 hours because of paralysis of the right leg and sharp pain. Therefore, during the third operation, the concentration of the continuous epidural anesthesia infusion was decreased to prevent complications, and a transversus abdominis plane block was added. The patient experienced no postoperative pain and fewer complications. We think that the combined use of these blocks provided good postoperative pain control with fewer complications.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Ueshima
authors.forename: Akiko
authors.initials: A
authors.lastname: Yoshioka
authors.forename: Chisato
authors.initials: C
authors.lastname: Sumi
authors.forename: Jun
authors.initials: J
authors.lastname: Ariyama
authors.forename: Akira
authors.initials: A
authors.lastname: Kitamura
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural / Q000379:methods*; D017604:Cesarean Section, Repeat; D005260:Female; D006801:Humans; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000517:prevention & control; D011182:Postoperative Care; D011247:Pregnancy