Evaluate the Feasibility of Surgical Transversus Abdominis Plane Block for Postoperative Analgesia After Cesarean Section.
Background
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.


Methods
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.'


Results
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.


Conclusion
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.
['Kakade|Aniket|A|0000-0002-7598-5209', 'Wagh|Girija|G|']
Transversus abdominis plane block Cesarean section Bupivacaine Rescue analgesia