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A review of peripheral nerve blocks for cesarean delivery analgesia
  1. Kelsey D Mitchell1,
  2. C Tyler Smith1,
  3. Courtney Mechling1,
  4. Charles B Wessel2,
  5. Steven Orebaugh1 and
  6. Grace Lim1,3
  1. 1 Anesthesiology & Perioperative Medicine, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  2. 2 Health Sciences Library, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  3. 3 Anesthesiology, Perioperative Medicine, Obstetrics & Gynecology, UPMC Magee Womens Hospital, Pittsburgh, Pennsylvania, USA
  1. Correspondence to Dr Grace Lim, Anesthesiology & Perioperative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; limkg2{at}upmc.edu

Abstract

Peripheral nerve blocks have a unique role in postcesarean delivery multimodal analgesia regimens. In this review article, options for peripheral nerve blocks for cesarean delivery analgesia will be reviewed, specifically paravertebral, transversus abdominis plane, quadratus lumborum, iliohypogastric and ilioinguinal, erector spinae, and continuous wound infiltration blocks. Anatomy, existing literature evidence, and specific areas in need of future research will be assessed. Considerations for local anesthetic toxicity, and for informed consent for these modalities in the context of emergency cesarean deliveries, will be presented.

  • cesarean section
  • anesthetics, local
  • nerve block
  • ilioinguinal
  • neuroaxial
  • postoperative analgesia
  • QLB
  • quadratus lumborum
  • regional block
  • trans abdominis plane
  • wound infiltration
  • wound infusion

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Footnotes

  • Twitter @LimGrapes

  • Contributors KDM, CTS: reviewed literature, wrote the manuscript and approved the final manuscript. CM: assisted in organizing the literature review and approved the final manuscript. CBW: designed and executed the literature search strategy. SO: wrote and approved the final manuscript. GL: wrote and approved the final manuscript.

  • Funding Dr Lim is supported in part by a grant from the NIH (K12HD043441).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.