Comparison of analgesic efficacy of transversus abdominis plane block with local wound infiltration using 0.25% levobupivacaine for post cesarean analgesia: A randomized controlled trial

The key component of Enhanced recovery after cesarian section (ERAC) is to improve maternal and child outcome and enhance recovery by dint of effective non opioid based pain control. We aim to compare the efficacy of Transverse abdominis plane (TAP) block with local wound infiltration for postoperative analgesia in cesarian section (CS).Eighty-two patients undergoing caesarean section under spinal anaesthesia were randomized to undergo local wound infiltration(Group I) (n=41) versus landmark guided bilateral TAP plane block (Group T) with 20ml of 0.25% levobupivacaine postoperatively Each patient was assessed post-operatively by a blinded investigator at regular intervals up to 24 h for visual analogue score (VAS). Requirement of analgesia, patient satisfaction, time for the first and second rescue analgesia, and the incidence of side effects was also noted. The median VAS was more in the group I compared to group II and was statistically significant (p=0.0032). The mean time to first rescue analgesia was prolonged in group I (4.060 ± 0.682 hrs) compared to group T (3.302 ± 0.519 hrs)(P< 0.001). The mean total analgesic requirement in 24 hours was reduced in group T (89.63 ± 41.82) as compared to group I (137.2 ± 33.13) (P<0.001. Group (T) compared to group I patient had a higher mean patient satisfaction score (1.487 ± 0.589) (2.097 ± 0.430) respectably (P < 0.001).TAP block provides better quality of analgesia and can be safely incorporated as a part of multi-model analgesic regimen postoperative pain over local infiltration in cesarian section.

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Transversus Abdominis Plane Block versus Wound Infiltration with Conventional Local Anesthetics in Adult Patients Underwent Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials

BioMed Research International ◽

10.1155/2020/8914953 ◽

2020 ◽

Vol 2020 ◽

pp. 1-18 ◽

Cited By ~ 2

Author(s):

Qiang Cai ◽

Mei-ling Gao ◽

Guan-yu Chen ◽

Ling-hui Pan

Keyword(s):

Patient Satisfaction ◽

Postoperative Pain ◽

Local Anesthetics ◽

Meta Analysis ◽

Adult Patients ◽

Transversus Abdominis ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Wound Infiltration ◽

Randomized Controlled

Background. How to effectively control the postoperative pain of patients is extremely important to clinicians. Transversus abdominis plane (TAP) block is a novel analgesic method reported to greatly decrease postoperative pain. However, in many areas, there still exists a phenomenon of surgeons using wound infiltration (WI) with conventional local anesthetics (not liposome anesthetics) as the main means to decrease postoperative pain because of traditional wisdom or convenience. Here, we compared the analgesic effectiveness of the two different methods to determine which method is more suitable for adult patients. Materials and methods. A systematic review and meta-analysis of randomized controlled trials (RCTs) comparing TAP block and WI without liposome anesthetics in adult patients were performed. Frequently used databases were extensively searched. The main outcomes were postoperative pain scores in different situations (at rest or during movement) and the time until the first use of rescue analgesics. The secondary outcomes were postoperative nausea and vomiting (PONV) incidence and patient satisfaction scores. Results. Fifteen studies with 983 participants met the inclusion criteria and were included in the present study. The heterogeneity in the final analysis regarding the pain score was low to moderate. The major results of the sensitivity analysis were stable. WI had the same analgesic effect as TAP block only at the one-hour postoperative time point (mean difference=−0.32, 95% confidence interval (-0.87, 0.24), P=0.26) and was associated with a shorter time until the first rescue analgesic and poorer patient satisfaction. Conclusion. TAP block results in a more effective and steady analgesic effect than WI with conventional local anesthetics in adult patients from the early postoperative period and obtains higher patient satisfaction.

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Evaluation of efficacy of bupivacaine and bupivacaine plus clonidine in transversus abdominis plane (TAP) block for postoperative analgesia: a prospective, randomized, double blind, comparative study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20174602 ◽

2017 ◽

Vol 5 (10) ◽

pp. 4588 ◽

Cited By ~ 1

Author(s):

Tauqeer Anjum Mir ◽

Aabid Hussain Mir ◽

Tantry Tariq Gani ◽

Abida Yousuf ◽

Sheikh Irshad Ahmad

Keyword(s):

Postoperative Analgesia ◽

Transversus Abdominis ◽

P Value ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Rescue Analgesia ◽

Group I ◽

Group Ii ◽

The Difference

Background: Pain is the commonest symptom encountered postoperatively and hence multimodal analgesia is tried to overcome it. In this study, we have compared bupivacaine and bupivacaine plus clonidine in transversus abdominis plane (TAP) block for postoperative analgesia in patients undergoing lower abdominal surgeries under spinal anaesthesia.Methods: Sixty ASA I and II patients in the age range of 18-60 years undergoing various lower abdominal surgeries were randomly divided into two groups, who were operated after giving spinal block using 2.5 ml of 0.5% hyperbaric bupivacine and 25ug of fentanyl. At the end of surgical procedure tranversus abdominis plane (TAP) block was given by giving 25 ml of injection bupivacaine 0.25% in group I and 25 ml of 0.25% of bupivacaine with 1 ug.kg-1 of clonidine in group II. Quality of analgesia was assessed by visual analogue scale (VAS), categorical pain scoring system and frequency of rescue analgesia given and duration was assessed with the time at which first rescue analgesia was given. Side effects of clonidine such as sedation, bradycardia and hypotension were also noted. The hemodynamic parameters like heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were noted for both the groups.Results: Demographic characteristics like age, weight, sex, ASA class and type of surgeries were comparable in both groups. SBP, DBP and HR were less in group II than in group I and was statistically significant (p-value<0.05). The overall mean VAS score in group I was 3.03 ± 1.57 and group II was 1.72 ± 1.02 with p-value of 0.0005 and hence better quality of analgesia in group II. Categorical pain scoring system also showed statistically better scores in group II than group I. The duration of analgesia which was calculated by mean time for first rescue analgesia in group I was 6.38 ± 2.56 hours and group II was 14.23 ± 4.63 hours with a p-value of <0.0001 and the difference was statistically significant. The mean number of doses of rescue analgesia in group I for the first 24 hours was 1.37 ± 0.89 and in group II was 0.60 ± 0.62 with a p-value of 0.0003 and the difference was statistically significant. Group II patients showed more sedation scores than group I patients (p-value <0.05). None of the patients had any episode of bradycardia or hypotension.Conclusions: Addition of clonidine 1 ug.kg-1 to 25 ml of 0.25% bupivacaine compared to 25 ml of 0.25% bupivacaine alone in tranverse abdominis plane (TAP) block improves quality of analgesia, increases duration of postoperative analgesia and decreases postoperative analgesic requirements with minimal side effects.

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Transversus abdominis plane block by landmark technique with ropivacaine versus bupivacaine for post-operative analgesia in patients undergoing lower segment caesarean section deliveries

Indian Journal of Clinical Anaesthesia ◽

10.18231/j.ijca.2021.118 ◽

2021 ◽

Vol 8 (4) ◽

pp. 551-555

Author(s):

Aishwarya M Chavan ◽

Geetha R Acharya ◽

Jyoti V Kale ◽

Nidhi R Dabral

Keyword(s):

Patient Satisfaction ◽

Caesarean Section ◽

Postoperative Period ◽

Transversus Abdominis ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Lower Segment ◽

Rescue Analgesia ◽

Lower Segment Caesarean Section ◽

Group B

Transversus Abdominis Plane (TAP) Block is an efficacious abdominal field block which is widely used component of multimodal analgesia. Compare the efficacy of Inj. Ropivacaine 0.2% and Inj. Bupivacaine 0.2% when used in TAP block for post-operative analgesia in lower segment caesarean section deliveries(LSCS) done under spinal anaesthesia. Randomized double blinded prospective study conducted after institutional ethics committee in our institute. We have recruited sixty patients scheduled for an elective LSCS which were enrolled into two groups to receive TAP block with bupivacaine 0.2% 15ml Group B (n=30) versus ropivacaine 0.2% 15ml Group R (n=30) + dexamethasone 2mg bilaterally. TAP block was administered on completion of surgery. Primary objective was to compare time to rescue analgesia in postoperative period. Secondary Objectives wereto compare hemodynamic response during postoperative period, measure the intensity of pain using visual analogue scale (VAS), number of analgesic doses in first 24 hours, patient satisfaction with pain management and complications if any.SPSS software 16 version. Time for rescue analgesia was shorter in Group B (6.7 hour) than in Group R (9.47 hour) (p = 0.00). VAS was lower in Group R. Higher dose of analgesics was required in Group B (p=0.008). All this led to higher patient satisfaction score in Group R. This study concludes that 0.2% ropivacaine provided a longer duration of analgesia compared to 0.2% bupivacaine when used in TAP block for post-operative analgesia in LSCS deliveries.

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Ultrasound Guided Quadratus Lumborum Block versus Transversus Abdominis Plane Block for Postoperative Analgesia in Patients Undergoing Total Abdominal Hysterectomy- A RCT

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/46063.14494 ◽

2021 ◽

Author(s):

Usha Shukla ◽

Pratima Kumari ◽

Jay Brijesh Singh Yadav ◽

Atit Kumar

Keyword(s):

Patient Satisfaction ◽

Postoperative Analgesia ◽

Abdominal Hysterectomy ◽

Transversus Abdominis ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Analgesic Requirement ◽

Patient Satisfaction Score ◽

Quadratus Lumborum ◽

Vas Scores

Introduction: Abdominal Hysterectomy (AH) is one of the most common surgeries performed in gynaecology and is associated with a medium to high pain level. Newly discovered peripheral blocks such as Transversus Abdominis Plane (TAP) block and Quadratus Lumborum (QL) block have gained immense popularity as an adjunct to regional and general anaesthesia for postoperative pain management and reducing analgesic requirements. Aim: To compare the analgesic efficacy of QL block with TAP block in patients undergoing total AH. Materials and Methods: This was a double-blinded Randomised Clinical Trial (RCT). The study population comprised of 105 patients posted for elective total AH under spinal anaesthesia. They were randomly allocated into three groups of 35 patients each. Group Q received bilateral QL block with 40 mL of 0.25% bupivacaine divided on either side, Group T received bilateral TAP block with 40 mL of 0.25% bupivacaine divided on either side and in Group C no block was given. Patients were monitored for Visual Analogue Scale (VAS) scores at 0, 15 minutes, 30 minutes, 1st, 2nd, 6th, 12th and 24th hour postoperatively, time for first analgesic requirement, total analgesic requirement in 24 hours and patient satisfaction score after 24 hours and also adverse effects, if any. Data were analysed using Statistical Package For The Social Sciences (SPSS) version 16 (Chicago, IL, USA) with independent t-test and Chi-square test as appropriate. The p<0.05 was considered statistically significant. Results: There were significantly lower VAS scores in group Q than group T at 2nd and 6th hour with p-value of 0.003 and 0.001, respectively. The time for first analgesic was early in group C with mean value of 1.37±0.74 hours and it was 4.63±0.97 hours in group T and 7.77±1.51 hours in group Q. The total analgesic requirement was lesser in group Q when compared to group C and T. Patient satisfaction score was comparable between group Q and T (p=0.97). No significant difference in complications among the three groups was observed (p=0.51). Conclusion: QL block is a better postoperative analgesic technique than TAP block for postoperative analgesia in hysterectomy patients.

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To Compare 0.25% Ropivacaine And 0.25% Bupivacaine In Tap Block For Postoperative Analgesia In Patients Undergoing Abdominal Surgeries.

Indian journal of applied basic medical sciences ◽

10.48165/ijabms.2021.233705 ◽

2021 ◽

Vol 23 (2) ◽

pp. 58-74

Author(s):

Vedanshi Himanshu Desai ◽

Jagruti R. Satasia ◽

Khushboo H. Desai ◽

Mitali G Patel ◽

Devyani D Solanki

Keyword(s):

Abdominal Wall ◽

Postoperative Analgesia ◽

Emotional Experience ◽

Sensory Nerves ◽

Transversus Abdominis ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Duration Of Action ◽

Rescue Analgesia ◽

Group I

INTRODUCTION Pain has been defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.1 Pain is the most dreaded problem which a person fears after any surgery. The transversus abdominis plane (TAP) block is an anaesthesia technique that provides analgesia to the parietal peritoneum as well as the skin and muscles of the anterior abdominal wall.4 Since the thoracolumbar nerves originating from the T6 to L1 spinal roots run into this plane and supply sensory nerves to the anterolateral abdominal wall5, the local anaesthetic spread in this plane can block the neural afferents and provide analgesia to the anterolateral abdominal wall. AIM AND OBJECTIVES Aim of study was to compare 0.25% Ropivacaine and 0.25% Bupivacaine in TAP block for postoperative analgesia in patients undergoing Abdominal Surgeries. The following parameters were compared: A. To study the effectiveness of transverses abdominis plane block for post-operative analgesia in Abdominal Surgeries. B. To compare the duration of analgesia and its effectiveness conferred by 0.25% Ropivacaine and 0.25% Bupivacaine. C. Total requirement of rescue analgesia. D. To watch for occurrence of side effects, if any MATERIALS AND METHODS A comparative clinical study was carried out on 60 adult patients belonging to ASA grade I or II, scheduled for elective Abdominal Surgeries. All patients were administered spinal anaesthesia with bupivacaine heavy 0.5%, 2.0-4.0 ml with 25 G spinal needle at L2-L3 or L3-L4 vertebral interspace. The patients were randomly allocated in two groups and study drug was injected at the end of surgery according to the group. The volume of administered drug kept constant (20 ml). Group I: Patients received TAP BLOCK on each side with 10ml 0.25% Ropivacaine. Group II: Patients received TAP BLOCK on each side with 10ml 0.25% Bupivacaine. CONCLUSION Transversus Abdominis Plane Block (TAP Block) provides better postoperative analgesia in various abdominal surgeries. 0.25% ropivacaine and 0.25% bupivacaine are equally effective in TAP block and provides effective postoperative analgesia but ropivacaine group shown longer duration of action compared to bupivacaine which was statistically significant without causing any increased adverse effects.

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Analgesic efficacy of ultrasound guided transversus abdominis plane (Tap) block after caesarean delivery- A prospective randomized controlled trial

Indian Journal of Clinical Anaesthesia ◽

10.18231/j.ijca.2021.038 ◽

2021 ◽

Vol 8 (2) ◽

pp. 185-190

Author(s):

Sonali Prajapati ◽

Nimisha Brahmbhatt

Keyword(s):

Caesarean Section ◽

Spinal Anaesthesia ◽

Elective Caesarean Section ◽

Analgesic Efficacy ◽

Transversus Abdominis ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Rescue Analgesia ◽

Analgesic Regimen ◽

Group B

Transversus abdominis plane block is facial plane block providing post-operative analgesia after lower abdominal surgeries as part of multi-modal analgesia. We evaluated analgesic efficacy of TAP block with Bupivacaine for 24hr after caesarean section done with pffannestiel incision under spinal anaesthesia, the pain being assessed with help of VAS. Total 130 parturients (ASA I OR II) posted for elective caesarean section under spinal anaesthesia were enrolled. They were allocated randomly in to two groups of 65 each. Group B patients received bilateral TAP block under USG at the end of surgery with 15ml of 0.25%Bupivacaine on each side while Group C patients did not receive TAP block. IV paracetamol 1gm was given in both groups as baseline analgesic at the end of surgery. Post-operative pain was assessed with VAS and rescue analgesia was given in form of Inj. Diclofenac Sodium Aq. at VAS score>4. Total rescue analgesia required in mg in post-operative 24 hours was noted.USG guided TAP block after caesarean section produced effective analgesia. Time for 1st rescue analgesia was delayed in group-B (mean+SD-12.25+4.54hr) than group-C (7.96+2.89hr) (P<0.001). Total analgesic requirement was reduced in group-B (107.35+50.32mg) than group-C (183+52.83mg) (P<0.001). USG-guided TAP block is easy to perform and effective as a component of multimodal analgesic regimen after caesarean section without any major complications.

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A Comparative Study Between Magnesium Sulfate Versus Morphine Added to Bupivacaine in Ultra-Sound Guided Transversus Abdominis Plane Block for Post-Operative Analgesia after Inguinal Herniorraphy

QJM ◽

10.1093/qjmed/hcaa039.045 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

A M Kamaly ◽

A M Khamies ◽

R M Hassan ◽

H A H Tawfik

Keyword(s):

Inguinal Hernia ◽

Magnesium Sulfate ◽

Transversus Abdominis Plane Block ◽

Transversus Abdominis ◽

Ultra Sound ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Rescue Analgesia ◽

Group I ◽

Inguinal Herniorraphy

Abstract Background Inguinal hernia considered the third common disease in surgeries for adult after acute appendicitis and proctologic disorders. About 20 millions of inguinal hernia repairs are performed globally. Inguinal herniorrhaphy is frequently associated with persistent postoperative pain. A significant proportion of pain experienced by patients undergoing abdominal surgeries is related to somatic pain signals derived from the abdominal wall. Aim of the Work The aim of this study is to assess the postoperative analgesic efficacy of Magnesium sulfate added to Bupivacine verus Morphine to Bupivacaine in ultrasound guided transversus abdominis plane (TAP) block after inguinal herniorraphy regarding the pain relief and the amount of rescue analgesia used postoperative. Patients and Methods The study was conducted on 45 randomly chosen patients in Ain Shams University Hospitals after approval of the medical ethical committee. They were allocated in three groups of 15 patients each: Group - I (B): received TAP block with Bupivacaine only as a “Control Group”. Group - II (B-MO): received TAP Block with Bupivacaine plus Morphine. Group - III (B-Mg): received TAP block with Bupivacaine plus Magnesium Sulfate. The three groups were adequately monitored and assessed intra- and post-operatively and they were compared regarding analgesic outcome by using the visual analogue scaling system, besides, recording time for first call for rescue analgesia and total consumption of it in the 1st 24 postoperative hours. Demographic data and post-operative hemodynamics were also assessed. Results The results of the study revealed that Magnesium added to bupivacaine better than Morphine added to Bupivacaine in transversus abdominis plane block regarding the postoperative analgesia after inguinal Herniorraphy. Conclusion In Conclusion the addition of MgSo4 as an adjuvant to bupivacaine in TAP block has shown superiority over either mono-therapy with bupivacaine or bupivacaine-Morphine combination in many aspects such as postoperative analgesic outcome assessed by VAS score, 1st time of rescue analgesia and without the pronounced side effects of the conventional postoperative opioids and less side effect than Morphine.

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A COMPARISON OF POST-OPERATIVE ANALGESIA WITH INTRAOPERATIVE PECTORAL NERVE BLOCK VERSUS CONVENTIONAL TECHNIQUE IN PATIENTS UNDERGOING MODIFIED RADICAL MASTECTOMY: A PROSPECTIVE, RANDOMIZED, AND DOUBLE-BLINDED STUDY

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2021.v14i12.43107 ◽

2021 ◽

pp. 69-72

Author(s):

ANKITA GAUTAM ◽

DAISY KARAN ◽

SWARNA BANERJEE ◽

PRERNA BISWAL ◽

NUPUR MODA

Keyword(s):

Patient Satisfaction ◽

Adverse Effects ◽

Radical Mastectomy ◽

Analgesic Efficacy ◽

Satisfaction Score ◽

Modified Radical Mastectomy ◽

Rescue Analgesia ◽

Patient Satisfaction Score ◽

Pectoral Nerve ◽

The Mean

Objective: We administered intraoperative pectoral nerve block after tissue resection was over and assessed its analgesic efficacy with conventional post-operative intravenous opioids in patients undergoing modified radical mastectomy. Methods: Sixty patients undergoing modified radical mastectomy surgery were enrolled in this prospective, randomized, and doubleblinded study. After general anesthesia and surgical resection in both groups, Group P received pectoralis (PECS) block under vision with ropivacaine at two points: 20 ml in the fascia over serratus anterior and 10 ml in the fascia between pectoral major and minor at the level of the third rib and Group T received tramadol (75 mg) in thrice daily frequency and 2% lignocaine infiltration at suture site. Primary objectives were to assess visual analog scale (VAS) scores over 24 h, time to first request for rescue analgesia (ketorolac) and total dose of analgesics needed, and secondary outcome was adverse effects and patient satisfaction score. “Mann–Whitney U test” and “Chi-square/Fischer exact test” were used for quantitative and categorical variables, respectively. Results: The mean time to the first rescue analgesia was 1175±120.21 and 1175±77.35 min and total analgesia requirement was equal (30.00±0.00 mg) in Group P and Group T, respectively. The mean VAS score over 24 h was comparable in both the groups. PECS block group had significantly less adverse effects and better satisfaction score. Conclusion: PECS block has similar analgesic efficacy as opioids but with better ability to mobilize the respective arm, better patient satisfaction score, and lesser adverse effects.

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Efficacy of Magnesium Sulfate Added to Local Anesthetic in a Transversus Abdominis Plane Block for Analgesia Following Total Abdominal Hysterectomy: A Randomized Trial

January 2018 - Pain Physician ◽

10.36076/ppj.2017.7.641 ◽

2017 ◽

Vol 7 (20;7) ◽

pp. 641-647

Author(s):

Ahmad M. Abd El-Rahman

Keyword(s):

Side Effects ◽

Magnesium Sulfate ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Transversus Abdominis ◽

Tap Block ◽

Group I ◽

The Mean ◽

Group Ii ◽

Double Blinded

Background: Major abdominal surgeries are associated with severe pain, which can affect respiratory and cardiac functions if insufficiently treated; this increases postoperative morbidity. Objective: We aim at evaluating the efficacy of magnesium sulfate as an adjuvant to local anesthetic in an ultrasound-guided transversus abdominis plane (TAP) block for postoperative analgesia in total abdominal hysterectomy. Study Design: A prospective, randomized, double-blinded clinical trial. Setting: An academic medical center. Methods: This study is registered at https://clinicaltrials.gov (no.: NCT02930707). This randomized, double-blinded clinical trial included 60 women undergoing total abdominal hysterectomy that were divided into 2 groups (30 patients per group). Group I received a TAP block with 20 mL per side of 0.25% bupivacaine plus 2 mL magnesium sulphate 10% (200 mg). Group II received a TAP block with 20 mL per side of 0.25% bupivacaine. Visual analog scale (VAS) scores, the time of the first analgesic request, total morphine consumption, and any side effects were assessed and recorded. Results: The mean postoperative VAS score was significantly reduced in group I compared to group II in all of the time-points except after 10 hours. The mean time of the first request for rescue analgesia was significantly prolonged in group I (15.67 hrs.) compared to group II (7.33 hrs.) (P < 0.001), and the mean total morphine consumption, over the first 24 hours postoperatively, was significantly lower in group I (7.63 ± 2.93 mg) than in group II (16.20 ± 3.24 mg) (P < 0.001). No significant difference in side effects was observed. Limitations: Sample size. Conclusion: The addition of 200 mg of magnesium sulfate to bupivacaine in an ultrasound-guided TAP block significantly reduced postoperative opioid requirements, prolonged the duration of analgesia, and reduced the VAS score in patients who underwent abdominal hysterectomy, without significant side effects. Key words: Magnesium sulfate, TAP block, postoperative pain, total abdominal hysterectomy

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Transversus abdominis plane block versus wound site infiltration using 0.25% bupivacaine for post-operative analgesia after caesarean delivery performed under subarachnoid block

Indian Journal of Clinical Anaesthesia ◽

10.18231/j.ijca.2021.042 ◽

2021 ◽

Vol 8 (2) ◽

pp. 209-213

Author(s):

Deepak Kumar ◽

Sonia Wadhawan ◽

Amit Kohli ◽

Poonam Bhadoria ◽

Abhijit Kumar

Keyword(s):

Postoperative Pain ◽

Pain Relief ◽

Caesarean Section ◽

Transversus Abdominis ◽

Tap Block ◽

Analgesic Requirement ◽

Rescue Analgesia ◽

Wound Site ◽

Group I ◽

Mean Time

: Transversus abdominis planeTAP) block has been described as an effective technique to reduce postoperative pain after caesarean section. Wound site infiltration (WSI) has been a traditional method for pain relief. In our study we attempt to compare the analgesic effect of TAP block with wound site infiltration after caesarean section. A randomized comparative study was conducted on 60 parturients. Patients were randomized into Group T (TAP block, n=30) and Group I (WSI, n=30). Spinal anaesthesia was administered and at the end of surgery, Group T was administered TAP block with 20 ml of 0.25% of bupivacaine on each side and in Group I, 20 ml of 0.25% bupivacaine was infiltrated along the wound site. Postoperatively parameters assessed were time to first rescue analgesia, postoperatively patient’s Numeric pain score (NPS) which was assessed periodically over 24hrs and if NPS ≥4 or patient demanded rescue analgesia, Inj diclofenac 75mg i/m was given as first rescue analgesic, total number of doses of first rescue analgesic given over 24hrs, total number of second rescue analgesic and complications were assessed.: The mean time to first rescue analgesia in Group T was 13.40±4.51 hours and in Group I was 6.20±4.25 hours (p-0.001). NPS at 2, 4,6,12 and 24 hours were lower in Group T compared to Group I. Also, analgesic requirement in first 24hours was significantly less in Group T (p-0.001).: TAP block was found to be superior to wound site infiltration in providing effective postoperative pain relief in patients undergoing caesarean section.

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