Analgesic Efficacy of Ultrasound Guided Transversus Abdominis Plane Block after Cesarean Delivery

Abstract

Introduction

Transversus abdominis plane (TAP) block is a simple and effective technique of providing analgesia for lower abdominal surgeries with easily identifiable landmarks. This study investigated the postoperative analgesic efficacy of bilateral ultrasound-guided transversus abdominis plane blocks, in patients undergoing caesarean delivery at Paropakar Maternity and Women's Hospital, Kathmandu, Nepal.

Methods

Seventy-four patients undergoing caesarean section under spinal anesthesia were randomized to receive TAP block with bupivacaine (n =37) versus no TAP group (n =37), in addition to analgesia with intravenous paracetamol 1gram 6 hourly. At the end of the surgery, an ultrasound-guided TAP block was given bilaterally using 0.25% bupivacaine or no TAP block. Each patient was assessed postoperatively at regular intervals up to 24 hours for numerical pain rating scale and requirement of pethidine. SPSS version 20.0 software was used. Demographic data were analyzed using Student’s t-test and Mann–Whitney U-test.

Results

The TAP block with bupivacaine compared with no TAP group reduced the postoperative numerical pain rating scale. The time to first analgesic demand time was shorter in the control group (79.05±26.99) minutes compared to the bupivacaine group (416.75±87.29) minutes (P <0.05) which was statically significant. The 24 hours pethidine requirement was less in the bupivacaine group (P<0.05). There were no complications attributable to the TAP block.

Conclusions

Bilateral ultrasound-guided TAP block significantly reduced postoperative pethidine consumption in 24 hours after cesarean delivery.