Observational studyBMC anesthesiology2016
Ultrasound anatomy of the transversus abdominis plane region in pregnant women before and after cesarean delivery.
Observational study in BMC anesthesiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 5 citations in OpenAlex.
- Article
- EVALUATION OF ULTRASONOGRAPHIC ANATOMY OF TRANSVERSUS ABDOMINIS PLANE BEFORE AND AFTER CESAREAN SECTION.Acta clinica Croatica · 2022Article
- Comparison of ultrasound-guided iliohypogastric/ilioinguinal nerve block and transversus abdominis plane block for analgesia after cesarean section: A retrospective propensity match study.Experimental and therapeutic medicine · 2019Article
- An Evaluation of the Adding Magnesium Sulfate to Ropivacaine on Ultrasound-Guided Transverse Abdominis Plane Block After Abdominal Hysterectomy.Anesthesiology and pain medicine · 2018Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAfter cesarean delivery, analgesia is often incomplete and a multimodal approach to analgesia is necessary. Transverse abdominal plane (TAP) block has been advocated in this setting, yet no systematic description of the ultrasound anatomy in pregnant women exists in the literature. Therefore, we aimed to describe the sonographical features of relevant structures in pregnant women before and after elective cesarean.
methodsSixty women at, or close to term scheduled for elective cesarean delivery underwent a standardized ultrasound examination before and after delivery. We assessed the visibility of the muscular layers and measured the distance from the skin to the layers of the abdominal wall muscles in the region for TAP block before and after cesarean section on both side.
resultsThe three muscular layers of the lateral abdominal wall (external oblique, internal oblique and transversus abdominis muscle) were visible in all examinations. Before cesarean section the median TAP distance was shorter: 2.9 cm (interquartile range 2.6-3.6) compared to 3.9 cm (3.1-4.5) after cesarean section (left side, p < 0.001). The external and internal oblique muscles were located closer to the skin surface before cesarean section. An increased body mass is associated with increased the TAP distance before and after birth (p < 0.001).
conclusionRelevant anatomical landmarks for a TAP block are sonographically well visible after cesarean delivery. Postoperatively, depth of the TAP as compared to before birth is increased significantly. Scanning the abdominal wall before CD will underestimate the target depth of the TAP after delivery. The obstetric anesthetist needs to be aware of these changes when planning a TAP block in the context of cesarean delivery.
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