EVALUATION OF ULTRASONOGRAPHIC ANATOMY OF TRANSVERSUS ABDOMINIS PLANE BEFORE AND AFTER CESAREAN SECTION.

Abstract

Transversus abdominis plane (TAP) block is used to provide analgesia after lower abdominal surgery operations. TAP block has been shown to reduce postoperative pain scores and side effects of opioids after cesarean section. Generally, TAP block was introduced after cesarean section. It is assumed that delivery affects sonographic characteristics of the abdominal wall. For this reason, ultrasonographic measurement of the anatomy of the region defined for TAP block was performed before and after cesarean section. It was aimed to determine the estimated TAP block distance in the population undergoing cesarean section. Fifty patients who underwent cesarean section in the operating room were included in the study. The inclusion criteria were ASA score I-II, age 18-45 years, gestational age ≥32 weeks, and cesarean section performed by Pfannenstiel incision. Data on patient age, weight, height, body mass index, gravidity, parity, gestational age (weeks), concomitant disease and allergy were recorded. According to the results obtained in the study, ultrasound should be performed if TAP block is accessible. Before cesarean section, the external oblique muscle and internal oblique muscle are closer to surface than after cesarean section since the TAP distance after pregnancy will be deeper. Systematic data on ultrasonographic anatomy of the abdominal wall in pregnant women have not yet been published. The obstetric anesthesiologist should be aware of these changes when planning a TAP block in the context of cesarean section. There is a need for larger prospective studies.