Evaluate the Feasibility of Surgical Transversus Abdominis Plane Block for Postoperative Analgesia After Cesarean Section
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Transversus abdominis plane (TAP) block is a fascial plane block providing postoperative analgesia after lower abdominal surgeries including Cesarean section. Conventionally, it is administered under ultrasound guidance or by blind technique. We studied a novel transperitoneal surgical TAP block for providing safe and effective analgesia after Cesarean section through transverse incision.
A hundred patients who fulfilled the inclusion criteria were included in the study after obtaining informed written consent. They were randomized in two groups: Group A with surgical TAP block and Group B without TAP block as control. Surgical TAP block was administered by transperitoneal route before the closure of peritoneum with 0.25% bupivacaine (dose adjusted with weight of the patient), and visual analogue score was assessed by a blind assessor. Time for rescue analgesia was noted and analyzed with the ‘two independent sample t test.’
The duration of postoperative analgesia in hours was significantly longer in the TAP block group compared with the control group (5.14 ± 1.63 vs 2.61 ± 0.89, p < 0.001). There was no reported complication of the surgical technique or any adverse effect of the used drug.
Surgical TAP block via the transperitoneal route is a safe, easy and effective mode of providing postoperative analgesia after Cesarean section. This technique does not need any costly specialist equipment, overcomes the technical limitations of ultrasound-guided TAP block and can be used in obese patients also. It has almost no side effects, and the technique can be easily mastered.
KeywordsTransversus abdominis plane block Cesarean section Bupivacaine Rescue analgesia
The authors would like to thank the Department of Anesthesiology, Bharati Vidyapeeth (Deemed to be University) Medical College, Pune, for their helpful suggestions and guidance during the study.
The authors have no funding to report.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
The study was approved by the Institutional Ethics Committee.
Informed written consent was obtained from all patients for being included in the study.
- 3.Birnbach DJ, Browne IM. Anesthesia for obstetrics. In: Miller RD, editor. Miller’s anesthesia. Philadelphia: Elsevier Churchill Livingstone; 2005. p. 2307–44.Google Scholar
- 4.Danelli G, Zangrillo A, Nucera D, et al. The minimum effective dose of 0.5% hyperbaric spinal bupivacaine for cesarean section. Minerva Anestesiol. 2001;67:573–7.Google Scholar
- 6.Hebbard P, Fujiwara Y, Shibata Y, et al. Ultrasound- guided transversus abdominis plane (TAP) block. Anaesth Intensive Care. 2007;35:616–7.Google Scholar