Effectiveness of Transversus Abdominis Plane Block in Post-Cesarean Section Pain Management: randomized controlled trial

Abstract

Background: Among the regional anesthetic methods applied in lower abdominal surgeries, including cesarean section, is the transversus abdominis plane (TAP) block. Postoperative pain control after cesarean section is significant to avert complications such as venous thromboembolism, improve early recovery, and improve the mother-child relationship. Between June 2020 and October 2021, we conducted a study at Beni Suef University Hospital to evaluate the use of TAP block in patients undergoing cesarean sections.

Methods: One hundred ladies under spinal anesthesia who were having cesarean sections participated in a prospective, randomized, controlled study (approval no. FMBSUREC/08032020/ El Mekkawy. Our research Participants were divided into one of the two groups at random. Bupivacaine was used in an ultrasound-guided TAP-block for Group I (n = 50), whereas saline solution was used as a placebo for Group II (n = 50). The Visual Analog Scale (VAS) and Verbal Descriptor Scale (VDS), opioid consumption, and ambulation time

Results: Groups were similar regarding age, BMI, and parity (p>0.05). However, TAP block was shown to reduce 24-hour cumulative morphine consumption (8.44±0.99 mg vs 11.00±0.86 mg, p<0.001), time to first analgesic request (219.26±56.06 vs 168.83±41.45 min, p=0.001), and to significantly lower 12, 24, and 48-hour postoperative pain scores (p<0.001). Additionally, the TAP group had a decreased incidence of nausea and sleepiness (p<0.05) and ambulated quicker (148.52 min vs. 207.92 min, p<0.001).

Conclusion: In addition to lowering opioid use, and improving maternal recovery block, when used in conjunction with multimodal analgesia, dramatically improves post-caesarean pain management.

Trial Registration: FMBSUREC/08032020/ El Mekkawy.