Abstract
Abstract Background The analgesic regimen needs to meet the goals of providing safe, effective analgesia, with minimal side effects for the patient, together with inhibition of trauma –induced nociceptive impulses. Objectives This study assessed the postoperative analgesic efficacy of transversus abdominis plane (TAP) block compared to local wound infiltration after cesarean section regarding the pain relief, effect on hemodynamics, requirement of first supplemental doses of analgesia and total number of doses received. All patients were informed with the procedure US guided TAP block and were trained to use the visual analogue scale (VAS). Patients and Methods The study was conducted on 90 randomly chosen patients aged 25 to 55 years, American Society of Anesthesiologists (ASA) class I or II scheduled for cesarean section surgery in Ain Shams University Hospitals after approval of the medical ethical committee. They were allocated in two groups of 45 patients each: TAP block Group: received general anesthesia and 20 ml of 0.25% bupivacaine on each side by midaxillary approach under ultrasound guidance. Local wound infiltration: received general anesthesia and with 0.25% bupivacaine 30 ml at surgical site. Results The results of the study revealed that the Patients who received TAP block had significantly lower pain scores for 12 h after operation and decreased total need of analgesic in first 12 h post-operative compared with patients who received wound infiltration. Conclusion Bilateral TAP block was effective in reducing postoperative pain scores for 12 hours and lower total 12 hours postoperative pethidine consumption after cesarean section under general anesthesia, compared to local wound infiltration. This technique can be a promising mode of postoperative analgesia where epidural catheter insertion is contraindicated.
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