Evidence map›Paper›PMID 34775851›Full record

ArticleWomen's health (London, England)

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.

Dennis E Feierman, Jason Kim, Aden Bronstein, Agnes Miller, Christein Dgheim, Viktoriya London, Avram Alter, Kalpana Tyagaraj

Open access · goldAbstract read
In one paragraph

Article in Women's health (London, England). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Dennis E FeiermanDepartment of Anesthesiology, Maimonides Medical Center, Brooklyn, NY, USA.ORCID 0000-0001-5824-5404
Jason KimDepartment of Anesthesiology, Maimonides Medical Center, Brooklyn, NY, USA.
Aden BronsteinDepartment of Anesthesiology, Maimonides Medical Center, Brooklyn, NY, USA.
Agnes MillerDepartment of Anesthesiology, Maimonides Medical Center, Brooklyn, NY, USA.
Christein DgheimDepartment of Anesthesiology, Maimonides Medical Center, Brooklyn, NY, USA.
Viktoriya LondonDepartment of OB/GYN, Maimonides Medical Center, Brooklyn, NY, USA.
Avram AlterDepartment of Anesthesiology, Maimonides Medical Center, Brooklyn, NY, USA.ORCID 0000-0002-8613-0695
Kalpana TyagarajDepartment of Anesthesiology, Maimonides Medical Center, Brooklyn, NY, USA.
Maimonides Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe 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.

methodsAfter 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.

resultsPost 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% (

conclusionNeuraxial 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.

Indexed as

COVID-19PandemicsAbdominal MusclesAnesthetics, LocalBupivacaineFemaleHumansLength of StayNarcoticsPregnancyRetrospective StudiesSARS-CoV-2Anesthetics, LocalBupivacaineNarcoticsanalgesiabupivacainelength of stayliposomal bupivacainepost-cesarean delivery pain

Identifiers

PMID34775851
PMCPMC8591775
OpenAlexW3213316389

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.