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Indian Journal of Anesthesia and Analgesia

Volume  6, Issue 3, May-June 2019, Pages 952-958
 

Original Article

Efficacy of Transversus Abdominis Plane Block for Post-operative Analgesia Following Lower Segment Cesarean Section

Mayur Narsingbhai Vasava1, Shilpa M. Doshi2, Chandrika Bhut3, Ravi Parmar4

1Senior Resident, N.D. Desai Medical College, Nadiad, Gujarat 387001, India. 2Associate Professor, 3,4Assistant Professor, Department of Anaesthesiology, Government Medical college and Sir Takhtasinhji hospital, Bhavnagar, Gujarat 364001, India.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6319.37

Abstract

Background and Objective: Transversus abdominis plane (TAP) block is a recently introduced regional technique that blocks abdominal wall neural afferents between T6 and L1 and thus can relieve pain associated with an abdominal incision of lower segment cesarean section. This study was conducted in 60 female patients to assess visual analogue scale (VAS) for pain score, requirements of rescue analgesics, patient’s and surgeon’s satisfaction score, side effects and complications if any. Method: After institutional review board approval and informed written consent from patients, Patients were randomly allocated to one of the two groups of 30 patients each. In Group T (TAP block with 15 ml of 0.25% Bupivacaine bilateral + Diclofenac Sodium 75 mg intravenous 8 hourly) given and in Group C (Diclofenac Sodium 75 mg Intravenous 8 hourly) given. The assessment of presence and severity of pain was done for 24 hours. At any point of time if VAS is ≥ 4, intravenously Paracetamol 1 gm was given to the patient as a rescue analgesic. Result: The mean VAS pain Score was comparable in each group and difference was significant statistically at 6, 8, 10, 12 hours (p<0.05). Requirement of rescue analgesia was reduced in patients of group T as compared to patients of group C. Hemodynamics remained stable in both the groups. Conclusion: TAP block as a part of multimodal analgesic regimen for post cesarean delivery provided reliable and effective analgesia in this study, and no complications due to the TAP block were detected.


Keywords : Transversus abdominis plane (TAP); Visual analogue scale; Diclofenac; Postoperative pain; Analgesia.
Corresponding Author : Shilpa M. Doshi