Efficacy of trans abdominis plane block for post cesarean delivery analgesia: A double-blind, randomized trial

Abstract

Background:The transverse abdominis plane (TAP) block, a regional block provides effective analgesia after lower abdominal surgeries if used as part of multimodal analgesia. In this prospective, randomized double-blind study, we determined the efficacy of TAP block in patients undergoing cesarean section.Materials and Methods:Totally, 62 parturients undergoing cesarean section were randomized in a double-blind manner to receive either bilateral TAP block at the end of surgery with 20 ml of 0.25% bupivacaine or no TAP block, in addition to standard analgesic comprising 75 mg diclofenac 8 hourly and intravenous patient-controlled analgesia (PCA) tramadol. Each patient was assessed at 0, 4, 8, 12, 24, 36, and 48 h after surgery by an independent observer for pain at rest and on movement using numeric rating scale of 0-10, time of 1st demand for tramadol, total consumption of PCA tramadol, satisfaction with pain management and side effects. Results: Use of tramadol was reduced in patients given TAP block by 50% compared to patients given no block during 48 h after surgery (P < 0.001). Pain scores were lower both on rest and activity at each time point for 24 h in study group (P < 0.001), time of first analgesia was significantly longer, satisfaction was higher, and side effects were less in study group compared to control group.Conclusion:Transverse abdominis plane block was effective in providing analgesia with a substantial reduction in tramadol use during 48 h after cesarean section when used as adjunctive to standard analgesia.

<p>Analgesic Efficacy of Erector Spinae Plane Block Compared with Intrathecal Morphine After Elective Cesarean Section: A Prospective Randomized Controlled Study</p>

“…Eisenach et al 11 demonstrated that acute pain following delivery represents a significant risk for persistent pain and depression, and it remains a challenge to provide postoperative pain management that is adequate and safe for both mother and baby. 12 Intrathecal morphine has been described as highly effective and is the mainstay method for pain control after cesarean section. 13 Unfortunately, its use is accompanied by undesirable drawbacks such as nausea and vomiting, urine retention, pruritus, and the risk of delayed maternal respiratory depression.…”

Ultrasound-guided transversus abdominis plane block for post-operative analgesia in patients undergoing caesarean section

“…The studies revealed that pain scores were lower and time of demand for first analgesia was significantly longer in study groups compared to control (no drug) groups. [ 25 26 ] Another study was conducted using 20 ml of 0.375% ropivacaine on either side, which included ASA II patients undergoing caesarean section under spinal anesthesia; reduction in mean VAS score ( P < 0.001) and reduced opioid requirement were observed. [ 27 ]…”

Efficacy of Double Pop Blind TAP Block – Double-Blinded Randomized Controlled Study

“…Prolongation of the immediate post-operative pain-free period comforts the patient quite a great deal because this is the period when the pain is intense. [5,[16][17][18]…”

“…[1][2][3][4] The benefits of TAP block are analgesia without sympathetic blockade and the consequent hypotension or bradycardia, unlike in neuraxial block; also, opioid-induced pruritus, nausea, and vomiting are generally not observed with TAP block. [5][6][7] The technical difficulty with ultrasoundguided TAP block and a dearth of time, discourage to perform the block; therefore, we designed this study to ascertain the efficacy of double pop blind TAP block, which can be delivered even in a resource-poor hospital set up.…”