Postoperative Analgesia After Caesarean Section Under ALR: TAP Block Versus Catheter Scar Infiltration

Study Overview
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Brief Summary
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The purpose of the multimodal postoperative analgesia is to improve the quality of analgesia and reduce side effects of morphine (nausea, vomiting, sedation, urinary retention, respiratory depression ...). In the case of caesarean sections, the quality of analgesia allows one hand to improve the mother-child relationship and the quality of breastfeeding, the other to reduce the risk of postpartum depression and chronic pain . Two methods of administration of local anesthetics have been proven effective for analgesia of the abdominal wall under umbilical: The Transversus Abdominal Block Plan (TAP Block) and infiltration of the scar continues operating. The TAP block was performed under ultrasound guidance by the anesthesiologist after the intervention in a single injection of local anesthetic in the abdominal wall and has a period of limited and variable. The infiltration continues catheter is placed by the surgeon before closing the wound and allows the infusion of local anesthetics for 48 hours. The purpose of this study was to compare morphine consumption between both techniques, and the quality of analgesia and side effects of morphine

Official Title
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Postoperative Analgesia After Caesarean Section Under ALR: TAP Block Versus Catheter Scar Infiltration

Conditions
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Scheduled Caesarian Section

Intervention / Treatment
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* Drug: Ropivacaine
* Device: The infiltration continues catheter


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Woman whose age is 18 years Encircled Woman requiring a scheduled(programmed) caesarian, under spinal anesthesia or died combined(organized) spinal anesthesia Woman ASA I and II Term = 37 LIMITED COMPANIES Woman primipare or not Woman having signed an informed consent writes and making a commitment to respect the instructions of the protocol Exclusion Criteria: Minor Woman Woman presenting a contraindication to the anesthesia périmédullaire: constitutional or acquired disorders(confusions) of the haemostasis, the allergy in the local anesthetics, the infectious context (hypertherm > 38.5 ° C) Woman presenting an intolerance or an allergy known about the morphine in the paracetamol or in AIN The surgical histories of laparotomy The morbid obesity BMI > 35 Dysgravidies Woman not being affiliated to the national insurance scheme Woman under legal protection Woman not having signed an informed consent

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: TAP block<br> | Drug: Ropivacaine<br>* comparaison of two methods of administration for analgesia using the same drugs in the same indication after Caesarean section<br>|
| Active Comparator: infiltration continues<br> | Device: The infiltration continues catheter<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Consumption morphinize | the cosumption of morphinize is collected since the first hours of comsumption to the 48 th hours | 48 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Analgesic efficiency | the Score of pain measured by simple numerical rating scales start the first hours one asks for a complementary analgesia to the 48 th hours | 48 hours |