To study efficacy of transversus abdominis plane block for post cesarean delivery analgesia-a randomised controlled double blinded trial

Primary Objectives
To study efficacy of TAP block for post cesarean delivery analgesia in terms of
1. Postoperative pain severity and level of sedation.
2. Analgesia need and improve patient satisfaction.
Secondary Objectives
1. To assess post-operative nausea &vomiting(PONV).
2. Comparison with available data.
Materials and Methods: Total 68 parturients undergoing cesarean section were randomized to 2 groups after approval of institutional ethical committee and with written informed consent to receive either bilateral TAP block at the end of surgery in group Swith 15 ml of 0.25% bupivacaine or no TAP block in group C, in addition to standard analgesic75 mg diclofenac 8 hourly. Assessment at ward at 0,4,8,12,24 hr for pain(VAS score),PONV and sedation was done. Additional use of rescue analgesic tramadol was noted. Difference between the two means was tested using student t test & p value <0.05 was considered significant.
Results: Demographic profile did not vary significantly in both groups.The VAS scores at 24hrs was 5.24 ± 0.92 at 24 hrs in S group vs 5.76 ± 0.74 in group C and vary significantly lower in the study group when compared to the control group at all time intervals (p<0.05).Time to first rescueanalgesic (7.15hrs vs 9.29hrs) and PONV at 8hrs (0.53 vs0.18) and 12hrs (0.12 vs 0) vary.Total requirement of rescue analgesic was also significantly reduced in the study group.
Conclusion: TAP block was effective in providing analgesia with reduction in tramadol use during 24hrs after cesarean section when used as adjunctive to standard analgesia.