Evaluation of 0.25% bupivacaine vs. 0.375% ropivacaine for postoperative analgesia using ultrasound guided transversus abdominis plane block for caesarean section: A comparative study

Abstract

Background: Pain after Caesarean section is described as moderate to severe by most patients. Ultrasound guided transversus abdominis plane (TAP) block is now increasingly being used for postoperative analgesia in lower abdominal surgeries. Hence this study was undertaken to compare 0.25% Bupivacaine with 0.375% Ropivacaine for postoperative analgesia using TAP block in caesarean section. Methods: Seventy patients were randomized into Group B (n = 35) and Group R (n = 35). TAP block was administered after completion of surgery under ultrasound guidance using 15 mL of 0.25% Bupivacaine in Group B and 15 mL of 0.375% Ropivacaine in Group R on each side of the abdomen. Time to requirement of first analgesic dosage was observed in both the groups. Total analgesic requirement in the first 24 h, visual analogue scale (VAS) scores at 2, 4, 6, 8, 12 and 24 h, patient satisfaction and complications were also noted. Results: Mean time for the first dose of rescue analgesia after completion of surgery was 298.2 ± 93.6 min in Group B and 447.6 ± 85.2 min in Group R (P = 0.0001). Total requirement of Diclofenac Sodium injection was 162.86 ± 46.88 mg in Group B whereas it was only 130.71 ± 44.49 mg in Group R (P = 0.003). VAS at 4,6 and 8 h after surgery were significantly lower in the Ropivacaine group. Conclusion: 0.375% Ropivacaine provided longer duration of analgesia and resulted in lesser analgesic requirement than 0.25% Bupivacaine when used in TAP block after caesarean section.