BACKGROUND: Postoperative pain is a matter of concern for all the patients undergoing surgery irrespective of age. Pain, when poorly controlled increases the post-operative morbidity and their sequelae. The transversus abdominis plane (TAP) block (classical or posterior approach) is a new method of providing postoperative analgesia in patients undergoing lower abdominal wall incisions. OBJECTIVE: To compare the effectiveness and duration of analgesia of TAP block versus intravenous analgesia in patients undergoing caesarean section. PATIENTS AND METHODS: A prospective randomized controlled double blind study was conducted in the department of Anaesthesiology, Gandhi Hospital, Secunderabad over a period of six months. Fifty patients were randomly selected to be enrolled in this study that was scheduled for Caesarean section via pfannenstiel incision. All patients were of ASA I-II physical status. Study group which consisted of 25 patients received TAP block with (bupivacaine 0.25%) (Group T) and the control group were given i.v diclofenac sodium 75mg (Group D). Inj. Tramadol 2mg/kg was given as rescue analgesic on patient's request. Patients were followed up at 0, 4, 8, 12, 16, 20, 24 hours post-operatively for pain. RESULTS: Our study has shown that 1) Patients in Group-T had good post-operative analgesia while compared to Group-D. 2) Pain scores also were less in Group-T for the next 24 hrs compared to Group-D. 3) Use of opioids was reduced in Group-T than Group-D. Rescue analgesic used in study group was 28% when compared to 100% in control group. CONCLUSION: US guided TAP block is a new technique which can be easily and safely performed in lower abdominal surgeries for post-operative analgesia. TAP block is more effective in the early post-operative period. In the present study there was significant decrease in requirement of opioids and also in pain scores in patients who received TAP block.
Background and objectives: Labor pain is a severe form of pain experienced by a woman, leading to tremendous stress. Several routes for labor analgesia have been tried. Entonox is a premixed homogeneous gas mixture of nitrous oxide and oxygen in the ratio of 50:50 providing conscious sedation in obstetrics during labor. It is a safe and effective analgesia for obstetrics use due to its properties of rapid onset, short half-life, and rapidly disappearing symptoms on withdrawal of the gas. Therefore, we aimed to evaluate the effect of Entonox on the severity and relief of labor pain during its various stages and its associated maternal or fetal side effects. Materials and Methods: A prospective randomized controlled trial (RCT) of 200 term pregnant mothers reporting in labor over a period of 2 months who were randomized into Entonox group and placebo oxygen control group was included in the study. Administration of both gases was done, and the pain scoring was recorded. Maternal and fetal complications were noted. Results: The intensity of labor pain was significantly lower in Entonox group as evident by lower pain scoring values. The mean duration of the active phase of labor in the Entonox group was comparable to the oxygen group. Maternal and fetal side effects were not significant in both groups. The mode of delivery is also comparable in both groups. Conclusion: Entonox usage in labor analgesia is a safe, effective, and inexpensive method of relieving labor pain, achieving immense patient satisfaction and making labor a pleasurable experience.
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