Efficacy of Trans-Abdominis Plane Block in Post Cesarean Delivery Analgesia

Abstract

Managing pain following cesarean section is challenging. Over recent years, there has been growing interest in regional nerve block techniques with promising results on efficacy, as they reduce postoperative pain and the need of supplemental analgesia, thereby lower the incidence of drug-related side effects. Aims are evaluated the efficiency of the transverse abdominis plane block in pain control in patients undergoing cesarean section. This is a prospective double-blind study which included a total of 70 adult parturients undergoing elective cesarean section. The recruited patients were randomly assigned to two equal groups: those received transverse abdominis plane block with 20 ml 0.25% bupivacaine and those received no block. Visual analogue score was used to assess pain at 2, 4, 6, 8, 12, 18 and 24 h postoperation. Time for rescue analgesia, as well as the total amount of tramadol that received by each patient, were calculated. In almost all postoperative time points, the mean pain score in transverse abdominis plane group was significantly higher than that of control group. Time to first analgesic administration was prolonged significantly in transverse abdominis plane group (8.46±4.12 hrs) as compared with control group (4.18±2.53 hrs). Mean tramadol requirement for transverse abdominis plane group was 154.8±61.13 mg and compared with 268.16±92.53 mg for control group, with a significant difference. The operative time correlated significantly with time for rescue analgesia and tramadol requirement. Transverse abdominis plane block could be an effective method in providing analgesia with a substantial reduction in pain score and tramadol requirement during the first 48 hrs after cesarean section when used as adjunctive to standard analgesia.