Analgesic Efficacy of Trans Abdominis Plane Block (TAP) in Women Undergoing Caesarean Section; A Randomized Controlled Trial

Abstract

Objective: To compare the analgesic efficacy of TAP block in providing post-caesarean analgesia with the control group, in terms of mean postoperative use of opioids

Methodology: This Randomized, single-blind control trial (registered with ClinicalTrial.gov NCT05831501 was conducted at Combined Military Hospital (CMH) Sargodha, Pakistan, from 1st June 2022- 31st Dec 2022. After applying inclusion and exclusion criteria sixty patients were randomly selected using non-probability, consecutive sampling. Patients in Group A had a bilateral TAP block with 20 ml of 0.25% bupivacaine following a caesarean delivery, while patients in Group B received 20 ml of saline. The total amount of opioids used in the first 24 hours following surgery was the primary outcome. Time of first rescue analgesia, mean pain score, and frequency of nausea vomiting in postoperative period was also assessed.

Results:  Bupivacain with TAP block (group A) decreased pain score at 6 and 12 hours and total opioid consumption within first 24 hours after the surgery. The TAP block also considerably reduced the requirement for initial rescue analgesia. The difference was not significant in terms of reduction in pain scores at 24 post-operative hours, post-operative nausea vomiting, and duration of hospital stay.

Conclusion: This study found that the TAP block prolongs the duration of postoperative analgesia in comparison to placebo. It reduces the average pain score and postoperative opioid intake up to 24 hrs after the surgery, making it a secure and reliable technique for controlling postoperative analgesia after a C-section.