Background: Transversus abdominis plane (TAP) block is a recently described technique to provide analgesia in lower abdominal surgery. The technique has been refined by ultrasound (US) guidance to deliver the local anaesthetic into the neurofascial plane between the internal oblique and the transversus abdominis muscles. We evaluated the analgesic efficacy of US-guided TAP block in patients undergoing caesarean delivery. Methods: Fifty women undergoing caesarean section were randomised to undergo bilateral TAP block with ropivacaine 0.5% (N = 25) versus placebo (N = 25), in addition to standard postoperative analgesia comprising of oral acetaminophen (600 mg) 6 hourly, with IV morphine (3 mg) analgesia for 'breakthrough' pain. Each patient was assessed postoperatively by a blinded investigator for morphine usage, average pain score, nausea, vomiting, pruritus, drowsiness and satisfaction with pain relief. Results: In the TAP group, postoperative morphine requirements up to 24 hours were significantly reduced (median 18.0 mg) compared with the placebo group (median 33 mg). Patients in the TAP group reported lower visual analogue scale scores than patients in the placebo group. Fewer patients required antiemetic in the TAP group. There were no local complications attributable to the TAP block. Conclusion: US-guided bilateral TAP block used in conjunction with oral acetaminophen significantly reduces the need for IV morphine and is an effective component in a multimodal strategy for postoperative analgesia following caesarean delivery.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.