Post Cesarean Section Pain Management by Transversus Abdominis Plane Block: Analytical Research

Objective: Non-opioid analgesia can be used in post-cesarean section (CS); transversus abdominis plane (TAP) block is the recent and widely investigated one with controversy about its efficacy in reducing post-CS pain and amount of opioid analgesia needed. To study the TAP block efficacy in postoperative analgesia and identify the satisfaction of patients with it. Material and Methods: A comparative prospective study was performed from November 2017 to November 2019. One hundred women underwent CS, 50 of which had general anesthesia followed by TAP block (the TAP group), versus 50 who underwent just general anesthesia (no TAP group). Monitoring of pain was scheduled at 1, 2, 4, 6, 12, and 24 hours by visual analog scale (VAS). The first time to require analgesia and overall analgesic dose in 24 hours was documented. After 24 hours, patient satisfaction with the relief of postoperative pain was documented. Results: Compared with the no TAP group, the TAP group exhibited significantly lower VAS from 1 hour up to 24 hours (p from <0.001 to 0.04) with a significantly higher mean time to first rescue analgesia (2.3±1.11), (10.5±6.43 hours), (p<0.001), and a significantly lower total tramadol need (179±25.54 mg), (51±26.46 mg), (p<0.001). Eight women demanded first rescue analgesia before the first 6 hours versus 48 in the no TAP group, and the patients' satisfaction score was higher. Conclusion: Postoperative analgesia by TAP block is effective and lowers postoperative rescue analgesic.