Efficacy of surgical transversus abdominis plane block in patients undergoing cesarean delivery

Abstract

Background: The surgical transversus abdominis plane (TAP) block is an established technique for postoperative analgesia following abdominal surgery. However, it has not been practiced frequently by obstetricians. This work was done to study the efficacy of the surgical TAP block after cesarean delivery (CD). Materials and methods: The study included 100 women undergoing CD in MVJ Medical College and Research Hospital, Hoskote, Bengaluru, Karnataka. The operating obstetrician performed a surgical TAP block for 50 participants in the “Study” group. Twenty milliliters of 0.25% bupivacaine was injected in the transversus abdominis neurofascial plane, on either side. Another 50 participants were included in the “Control” group. Postoperatively, visual analog scores (VAS) for pain were monitored for 24 hours. Whenever the patient demanded rescue analgesia or VAS was recorded as 4 or more, rescue analgesia was administered with intravenous injection tramadol 50 mg. The time of the first rescue analgesia and the total dose of rescue analgesics required in the first 24 hours were recorded. The patients in the “Control” group routinely received intravenous injection tramadol 50 mg, 8th hourly for pain relief. Results: The difference in the mean VAS score at all time intervals between the two groups was statistically significant (p < 0.05). The mean time to first rescue analgesia in the “Study” group and “Control” group was 11.7 ± 7.344 and 2.1 ± 1.125 hours, respectively, and the total tramadol consumption was 50 ± 28.571 and 180 ± 26.726 mg, respectively. This difference was statistically highly significant (p < 0.001). Conclusion: Surgical TAP block is an important adjunct in the multimodal pain management strategy and should be practiced more often in obstetric practice.