Analgesic efficacy of ultrasound guided transversus abdominis plane (Tap) block after caesarean delivery- A prospective randomized controlled trial

Abstract

Transversus abdominis plane block is facial plane block providing post-operative analgesia after lower abdominal surgeries as part of multi-modal analgesia. We evaluated analgesic efficacy of TAP block with Bupivacaine for 24hr after caesarean section done with pffannestiel incision under spinal anaesthesia, the pain being assessed with help of VAS. Total 130 parturients (ASA I OR II) posted for elective caesarean section under spinal anaesthesia were enrolled. They were allocated randomly in to two groups of 65 each. Group B patients received bilateral TAP block under USG at the end of surgery with 15ml of 0.25%Bupivacaine on each side while Group C patients did not receive TAP block. IV paracetamol 1gm was given in both groups as baseline analgesic at the end of surgery. Post-operative pain was assessed with VAS and rescue analgesia was given in form of Inj. Diclofenac Sodium Aq. at VAS score>4. Total rescue analgesia required in mg in post-operative 24 hours was noted.USG guided TAP block after caesarean section produced effective analgesia. Time for 1st rescue analgesia was delayed in group-B (mean+SD-12.25+4.54hr) than group-C (7.96+2.89hr) (P<0.001). Total analgesic requirement was reduced in group-B (107.35+50.32mg) than group-C (183+52.83mg) (P<0.001). USG-guided TAP block is easy to perform and effective as a component of multimodal analgesic regimen after caesarean section without any major complications.