gynecology and obstetrics medical project, gynecology journal, obstetrics, gynecologic oncology, reproductive medicine, gynecological endoscopy, ultrasonography, gynecology articles

Ginekologia i Poloznictwo
ISSN 1896-3315 e-ISSN 1898-0759

The efficacy of ultrasound guided transversus abdominis plane (TAP) block versus local wound infiltration for post-operative analgesia after cesarean section under general anesthesia: A randomized controlled double-blinded clinical trial


Abstract

Author(s): Haitham A. Sabaa, Ayman A. Abo Elnor, Mohamed A. Abdelnaiem, Rana Moheb Soliman Ahmed* and Salma A. Nassar

Aim: Cesarean Section (CS) sometimes causes post-surgical pain, which prevents early discharge and breastfeeding. We here compared analgesic effectiveness of bilateral US guided Transversus Abdominis Plane block (TAP) vs. single-shot local anesthetic Wound Site Infiltration (WI) after CS under general anesthesia.

Patients and methods: The present randomized controlled trial was conducted at Ain Shams University hospitals from January to June 2021 on 195 cases. Patients were divided into 3 groups (65 in each): TAP group, infiltration group, and control group.

Results: Demographic characteristics did not differ between the three. In the following outcomes, TAP was most favorable, followed by WI, and worst in control group. In almost all these, significance was observed. 1) Postoperative patients’ pain perception (at hours 1, 2, 4, 6, 12 and 24); 2) Patient satisfaction; 3) Time/rate to/of first rescue analgesia; 4) Total NSAID dose; 5) Time/rate to/of first opioid dose; 6) The onset of mobilization; 7) Postoperative nausea and vomiting. Postoperative pruritis were not observed in all.

Conclusion: TAP block provided better pain relief, less analgesic requirement, and early mobilization than local wound infiltration after CS under general anesthesia.