Purpose of Review

In this review, we discuss surgical infiltration and various abdominal wall blocks, including transversus abdominis plane (TAP) block and quadratus lumborum blocks, and review the literature on the evidence behind these approaches and analgesia for cesarean delivery (CD).

Recent Findings

Adequate pain management in the parturient following CD is important to facilitate early ambulation and neonatal care while also improving patient satisfaction and decreasing hospital length of stay. Neuraxial opioids have been a mainstay for postoperative analgesia; however, this option may not be available for patients undergoing emergency CD and have contraindications to neuraxial approaches, refusing an epidural or spinal, or with technical difficulties for neuraxial placement. In such cases, alternative options include a fascial plane block or surgical wound infiltration. The use of regional blocks or surgical wound infiltration is especially recommended in the parturient who does not receive neuraxial opioids for CD.

Summary

Adequate postoperative analgesia following CD is an important component of the overall care of the parturient as it helps facilitate early mobilization and improve patient satisfaction. In conclusion, the use of abdominal fascial plane blocks or surgical wound infiltration is recommended in the parturient who does not receive neuraxial opioids for CD.

中文翻译：

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剖宫产后区域麻醉腹部阻滞和局部浸润：现有证据回顾

审查目的

在这篇综述中，我们讨论了手术浸润和各种腹壁阻滞，包括腹横肌平面 (TAP) 阻滞和腰方肌阻滞，并回顾了有关这些方法和剖宫产 (CD) 镇痛证据的文献。

最近的发现

CD 后产妇的充分疼痛管理对于促进早期下床活动和新生儿护理非常重要，同时还可以提高患者满意度并缩短住院时间。椎管内阿片类药物一直是术后镇痛的主要药物。然而，该选项可能不适用于接受急诊 CD 且有椎管内入路禁忌症、拒绝硬膜外或脊柱穿刺或椎管内放置技术困难的患者。在这种情况下，替代选择包括筋膜平面阻滞或手术伤口浸润。对于未接受椎管内阿片类药物治疗 CD 的产妇，特别推荐使用区域阻滞或手术伤口浸润。

概括

CD 后充分的术后镇痛是产妇整体护理的重要组成部分，因为它有助于促进早期活动并提高患者满意度。总之，对于未接受椎管内阿片类药物治疗的 CD 的产妇，推荐使用腹筋膜平面阻滞或手术伤口浸润。