The Analgesic Efficacy of Ultrasound-guided Transversus Abdominis Plane (TAP) Block Combined With Oral Multimodal Analgesia In Comparison With Oral Multimodal Analgesia After Caesarean Delivery: A Randomized Controlled Trial
Abstract Background: The transversus abdominis plane (TAP) block is used increasingly in parturients after caesarean delivery. This is a randomized controlled trial to evaluate the effectiveness of bilateral single-shot TAP blocks in patients who received multimodal oral analgesia for postoperative pain relief.Methods: Parturients who were scheduled for elective caesarean delivery under spinal anaesthesia were recruited and randomized to receive bilateral single-shot of TAP blocks or placebo in addition to multimodal oral analgesia which consisted of regular tramadol, celecoxib and paracetamol, with oral oxycodone used as rescue for breakthrough pain. Only parturients in TAP group would receive the TAP blocks with an injection of 15ml (0.25%) ropivacaine on each side under aseptic techniques. All the parturients were evaluated for pain or related complications in the first 24 hours after surgery. Primary outcome is the percentage of parturients who required oxycodone as rescue analgesia. Results: Eighty and seventy-nine parturients were allocated to TAP and placebo group respectively. Nine out of 79 (11.4%) parturients in TAP group and fifteen out of 73 (20.5%) parturients in placebo group required oxycodone for breakthrough pain, P = 0.122.Conclusions: Bilateral single-shot of TAP blocks confer little additional benefit when multimodal oral analgesic regimen is used for pain control after caesarean section under spinal anaesthesia.Trial registration:Clinical Trial Registry of China (http://www.chictr.org.cn, ChiCTR-INR-16010130). Retrospective registered on Dec 12, 2016