Wubet Dessie¹, Eskeziaw Agidew²

¹MSc in Advanced Clinical Anesthesia, Menelik Health Science College

²Assistant professor in Public Health, Debremarkos University

Corresponding Author: Wubet Dessie, MSc in Advanced Clinical Anesthesia, Menelik Health Science College, Email: wubetdessie21@gmail.com; Ph: +251913425312.

Citation: Wubet Dessie, Eskeziaw Agidew (2023). Assessing the Analgesic Efficacy of Transversus Abdominis Plane Block after Cesarean Section Delivery under Spinal Anesthesia as Part of Multimodal Analgesia. A Prospective Cohort Study. Int J Surg Anesth, 1(1),1-3.

Copyright: © 2023, Wubet Dessie. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

ABSTRACT

Background: Pain is inevitable during surgery and pain management is the main issue in anesthesia and surgery. An ideal analgesic technique, offering pain-free treatment, free of side effects and cost-effective agent was needed to achieve good pain management. Therefore, this prospective study was conducted to evaluate efficacy of transverses abdominals plane block after Cesarean Section Delivery under Spinal Anesthesia as Part of multimodal analgesia among two comparative groups within 12 hours.

Objectives

To assess analgesic efficacy of transversus abdominals plane block after cesarean section delivery under spinal anesthesia at Zewditu Memorial Hospital from February to March 2016.

Methods

A prospective observation was done on 42 patients undergoing caesarean section delivery under spinal anesthesia. Those who undergo TAP block with bupivacaine (n=21) as exposed group and non-TAP (n = 21) with standard analgesia with intravenous agents were followed for 12 hours postoperatively. Each patient was observed post-operatively by an investigator for visual analogue score (VAS) at 2, 4, 6 and 12 hours, time to 1st analgesic request and total analgesic consumption within the first 12 postoperative hours were also recorded and compared to see effect of TAP. A data analysis was conducted by SPSS version 20.0 software. The mean and standard deviation of the comparative group was analyzed by using paired student’s t -test. The significance difference was identified based on p-value less than 0.05.

Results

Postoperative VAS outcomes based for TAP group and non- TAP group include at 2 hours (5.23±3.34) vs (15.28±6.51), at 4 hours (7.09±3.11) vs (17.52 ± 3.9), at 6 hours (8.9±4.63) vs 21.04±5.06) and at 12 hours (11.33 ± 4.98) vs (25.2 ± 5.9). Tramadol consumption within the 1st 12 postoperative hours was 800 mg in TAP groups and 2350 mg in non-TAP groups. The TAP block group showed longer duration of time to 1st analgesic request than none TAP group (mean ± SD) (571.42 ±177.6) minutes vs (142.85 ± 48.28) minutes respectively. There was also decreased postoperative analgesic consumption and increased time to first request for analgesia in TAP group.

Conclusion and Recommendation

Patients with bilateral single injection of TAP block showed prolonged the time to 1st analgesic request, reduced total postoperative analgesic consumption and had lower postoperative severity of pain when compared with non TAP groups in patients after cesarean section under spinal anesthesia when it is used as part of multimodal analgesia. We recommend TAP block as part of multimodal analgesia after cesarean delivery. In addition, further study to find out the effect of TAP block after 12 hr.

KEYWORDS: Analgesic Efficacy; Transversus Abdominis Plane Block; Cesarean Section Delivery; Visual Analogue Scale