Abstract
Introduction: Transversus abdominis plane (TAP) block is a regional anesthesia that involves the infiltration of local anesthetic in between the internal oblique and transversus abdominis muscle plane. This block provides post-operative analgesia and reduces the requirement of opioids consumption.
 Objective: To assess the effectiveness of TAP block in providing postoperative analgesia in women undergoing caesarean section.
 Methodology: This was a hospital based prospective, comparative, cross sectional study conducted in 70 patients from 17th September 2018 to 17th February 2019 undergoing caesarean section under spinal anesthesia. Patients were divided into two groups. Group A patients received TAP block with 0.5% Ropivacaine versus Group B patients received injection paracetamol 1gm intravenous every 8 hourly as a standard and routine analgesic. At the end of the surgery, TAP block was performed by anesthesiologist and assessment of postoperative pain using a visual analogue pain score at every 1 hour, 3 hour, 6 hour, 12 hour and 24 hour by trained staffs at postoperative ward. Then, depending upon the severity of the pain injection fentanyl 1mcg/kg intravenous was given as rescue analgesia. Short assessment of patient satisfaction (SAPS) score was also assessed 24 hours postoperatively.
 Results: Compared to control group, in women who received TAP block, there was statistically significant reduction in pain at 3 hr, 6 hr, 24 hrs. However at 12 hrs there was no significant difference in the pain score. The cumulative fentanyl requirement was also significantly less in the TAP block group at all the time points.
 Conclusion: The TAP block provided highly effective postoperative analgesia following caesarean section and reduces the fentanyl requirement in the first 24 hour.
Highlights
Depending upon the severity of the pain injec on fentanyl 1mcg/kg intravenous was given as rescue analgesia
A er informed wri en consent, 70 adult parturients belonging to American Society of Anesthesiologists physical status I and II requiring elec ve or emergency caesarean sec on were included in this double blind study whereas pa ents with BMI >= 30kg/m2, with any contraindica on to spinal anesthesia, who were unable to understand visual analogue scale (VAS), history of allergy to drugs used in the study and pa ents requiring general anesthesia for obstetric or anesthe c reason were excluded from the study
The present study demonstrates transverses abdominis plane (TAP) block with 0.5% ropivacaine provided effec ve postopera ve analgesia, significantly reduced post opera ve opioid consump on and improved pain score
Summary
The transverses abdominis plane (TAP) block is a commonly used peripheral nerve block where soma c nerves supplying the anterior abdominal wall is being anesthesized by deposi on of local anesthe c at the site of transversus abdominis plane. The transversus abdominis plane is the fascial plane between the internal oblique and the transversus abdominis muscle containing the thoracolumbar nerves T10 toLocal anesthe c agent deposited at this space results in myocutaneous sensory blockade. It is a regional anesthesia that has become increasingly popular over the last decade.Nerve root or myofascial irrita on at the abdominal wall is a common cause of pain following surgeries such as caesarean sec on, cholecystectomy, prostatectomy, hysterectomy and transplant surgery. The transversus abdominis plane (TAP) block is a regional block that provides adequate and effec ve postopera ve analgesia in pa ents undergoing above surgery with midline infra-ubilical incision.2This technique was first introduced in 2001 by Rafi as the one-pop technique. Later on, it was modified by McDonnell who described it as a “two pop” technique using regional anesthesia via a blunt needle perpendicular to the skin, just superior to the iliac crest and behind the mid-axillary line.. The transverses abdominis plane (TAP) block is a commonly used peripheral nerve block where soma c nerves supplying the anterior abdominal wall is being anesthesized by deposi on of local anesthe c at the site of transversus abdominis plane.. The transversus abdominis plane (TAP) block is a regional block that provides adequate and effec ve postopera ve analgesia in pa ents undergoing above surgery with midline infra-ubilical incision.. The transversus abdominis plane (TAP) block is a regional block that provides adequate and effec ve postopera ve analgesia in pa ents undergoing above surgery with midline infra-ubilical incision.2 This technique was first introduced in 2001 by Rafi as the one-pop technique..
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