Ultrasound anatomy of the transversus abdominis plane region in pregnant women before and after cesarean delivery

Background: After cesarean delivery, analgesia is often incomplete and a multimodal approach to analgesia is necessary. Transverse abdominal plane (TAP) block has been advocated in this setting, yet no systematic description of the ultrasound anatomy in pregnant women exists in the literature. Therefore, we aimed to describe the sonographical features of relevant structures in pregnant women before and after elective cesarean. Methods: Sixty women at, or close to term scheduled for elective cesarean delivery underwent a standardized ultrasound examination before and after delivery. We assessed the visibility of the muscular layers and measured the distance from the skin to the layers of the abdominal wall muscles in the region for TAP block before and after cesarean section on both side. Results: The three muscular layers of the lateral abdominal wall (external oblique, internal oblique and transversus abdominis muscle) were visible in all examinations. Before cesarean section the median TAP distance was shorter: 2.9   cm (interquartile range 2.6 – 3.6) compared to 3.9   cm (3.1 – 4.5) after cesarean section (left side, p  
Source: International Journal of Bipolar Disorders - Category: Psychiatry Authors: Source Type: research