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

The Journal of Obstetrics and Gynecology of India volume 69, pages 330–333 (2019)Cite this article

Abstract

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.

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Acknowledgements

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.

Funding

The authors have no funding to report.

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Affiliations

  1. Department of Obstetrics and Gynecology, Bharati Vidyapeeth (Deemed to be University) Medical College, Pune, India

    Aniket Kakade & Girija Wagh

  2. Bharati Hospital and Research Centre, Pune, Maharashtra, 411043, India

    Aniket Kakade & Girija Wagh

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  1. Aniket Kakade
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  2. Girija Wagh
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Correspondence to Aniket Kakade.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

The study was approved by the Institutional Ethics Committee.

Informed Consent

Informed written consent was obtained from all patients for being included in the study.

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Dr. Aniket S. Kakade, M.D., D.G.O., F.C.P.S., D.N.B. is an Associate Professor, Fellow in High Risk Pregnancy and Critical Care Obstetrics, Bharati Vidyapeeth (Deemed to be University) Medical College, Pune, India. Dr. Girija N. Wagh, M.D., F.I.C.O.G. is a Professor and Unit In-charge, Bharati Vidyapeeth (Deemed to be University) Medical College, Pune, India.

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Kakade, A., Wagh, G. Evaluate the Feasibility of Surgical Transversus Abdominis Plane Block for Postoperative Analgesia After Cesarean Section. J Obstet Gynecol India 69, 330–333 (2019). https://doi.org/10.1007/s13224-019-01241-3

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  • DOI: https://doi.org/10.1007/s13224-019-01241-3

Keywords

  • Transversus abdominis plane block
  • Cesarean section
  • Bupivacaine
  • Rescue analgesia