Tap Blocks
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- Today i'm having my second elective cesarean section
- I can't wait to meet our second baby!!
- Now that we're here, i'm starting to feel nervous and scared, especially about the pain after
- Last time I had so much pain afterwards and needed lots of pain medication
- Everything will be ok, but lets talk to the staff to get more information
- Hi we're your anaesthetic team, i'm the nurse and this is the anaethetist
- we're here to manage your pain
- I understand you are scared about the pain you may feel, but here we use a variety of methods to help manage any pain you may have, this includes the use of ilioinguinal-transversus abdominis plane nerve blocks aka an I-TAP block
- A nerve block that sounds scary,How is this performed?
- First I will locate the correct area to inject this is 2 cm medial and 2 cm superior to the anterior superior iliac spine. Once I feel a fascial pop I will inject 10ml Ropivacaine 0.33%. the local anaesthetic will be injected between the internal and external oblique muscles.
- We will then advance the needle until a second fascial pop is felt and will then inject 20ml Ropivacaine 0.33% into the transverse abdominis plane. This is done on both sides.
- I've had a TAP block before, Why not just do that again?
- I can help with this one! Studies have found that a TAP block may not completly cover the nerves T10-LI, An I-TAP block may be more reliable as a more anterior approach is taken
- There are minimal risks accociated with this procedure and studies have shown a 59% reduction in post-op Fentanyl usage and a decrease in pain scores both on movement and at rest
- Ok, lets do it!
- 24 HOURS LATER
- I havn't needed anywhere near as much Fentanly as last time
- I'm a big sister!
- Yeah, and you also havn't had as much pain overall whenever you've moved
- Having a spinal anaesthetic, suppositries and the I-TAP has made this a great experience and my pain has been really well managed
- There are minimal side effects and the I-Tap can be performed quickly
- I-TAP nerve blocks in conjunction with a spinal anaesthetic and suppository medications has been shown to reducde post-operative PCA Fentanyl usage and decrease post-op pain on movement and at rest
- The use of a more anterior approach may make it more reliable then an TAP block
- Staker, J, Carlson, D, Lim, A, Liu, D, Church, R,Panahkhahi, M & LeCong, T 2018, ‘A triple-blind, placebo-controlled randomised trial of the ilioinguinal-transversus abdominis plane (I-TAP) nerveblock for elective caesarean section’, Anaesthesia,vol. 73, no. 5, pp. 594–602, viewed 1 September 2019, UTAS Library
- Thankyou.
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