RT Journal Article
SR Electronic
T1 OP028 Noval anterior cul de sac catheter further decreases opioid requirements compared to a 10-year established eras with tap following cesarean sections
JF Regional Anesthesia & Pain Medicine
JO Reg Anesth Pain Med
FD BMJ Publishing Group Ltd
SP A16
OP A17
DO 10.1136/rapm-2023-ESRA.28
VO 48
IS Suppl 1
A1 Burns, Michael
A1 Bellows, Brooke
A1 DuBois, Ashley
A1 Bruce, Lexis
YR 2023
UL http://rapm.bmj.com/content/48/Suppl_1/A16.2.abstract
AB Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submission Application for ESRA Abstract Prizes: I don’t wish to apply for the ESRA PrizesBackground and Aims Cesarean surgical deliveries account for 31.8% of deliveries worldwide and 38 million projected by 2030. To reduce pain and suffering due to visceral and somatic pain, several multimodal ERAS protocols including various plane type blocks have been developed and utilized to promote recovery and minimize opioids. This study aimed to compare ERAS protocols utilizing either an Anterior Cul de Sac catheter or TAP block to further decrease opioid requirements from a well-established 10-year protocol requiring a mean morphine consumption of 1.7 mg during POD-0.Methods A retrospective chart analysis of 81 cesarean patients that received a standard ERAS protocol including spinal anesthesia with 0.1mg of morphine and NSAIDS. Group 1 received single injection bilateral TAP blocks with 15 mL 0.5% ropivacaine. Group 2 received ACDS catheter with 15 mL bolus 0.5% ropivacaine followed by 10 mL/hr 0.2% ropivacaine infusion for 54.5 hours. The primary outcome measured was opioid consumption during postoperative day (POD) 0 through 3.View this table:Abstract OP028 Table 1 View this table:Abstract OP028 Table 2 DemographicsResultsAbstract OP028 Figure 1 Pain scoresResults Subjects that received ACDS catheters consumed significantly less opioids as measured in morphine equivalents (mg) in comparison to the bilateral TAP block patients on POD 0 (average of 0.39 mg versus 1.68 mg respectively; p=0.034) and POD 1 (average of 2.21 mg versus 4.87 respectively; p=0.034). Total opioid consumption for the entire hospital stay was significantly less in the ACDS group in comparison to the TAP group (average of 3.4 mg versus 8.1 mg respectively; p=0.024).Conclusions The ACDS catheters reduce opioid requirements compared to the TAP blocks with longer analgesia without increasing pain scores.