Assessing the Analgesic Efficacy of Transversus Abdominis Plane Block After Cesarean Section Delivery Under Spinal Anesthesia as Part of Multimodal Analgesia
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Date
2016-03
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Addis Abeba University
Abstract
Background: Transverses abdominals plane block was a kind of nerve block performed on the triangle
of petit to block a number of abdominal nerves.
Objectives: To assess analgesic efficacy of transversusabdominis plane block after cesarean
section delivery under spinal anesthesia at zewditu memorial hospital from February to march
2016.
Methods: A prospective cohort study design was conducted. 42 patients undergoing caesarean
section under spinal anesthesia were followed postoperatively. Those who undergo TAP block
with bupivacaine (n = 21) versus non-TAP (n = 21) with standard analgesia with intravenous
agents were followed. Each patient was assessed post-operatively by a blinded investigator for
visual analogue score (VAS) at 2, 4, 6 and 12 hours, time to 1st analgesic request and total
analgesic consumption with in the 1st 12 postoperative hours. SPSS window version 20.0
software was used for analysis.
Results: Postoperative VAS outcomes based on( mean ±SD) for TAP group and non- TAP group
include at 2 hr (5.23±3.34) vs (15.28±6.51), at 4 hr (7.09±3.11) vs (17.52 ± 3.9) , at 6 hr
(8.9±4.63) vs 21.04±5.06) and at 12 hr (11.33 ± 4.98) vs (25.2 ± 5.9).There was also decreased
postoperative analgesic consumption and increased time to 1st analgesia in TAP group.
Conclusion and Recommendation: It is concluded that bilateral single injection of TAP block
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. I
recommend TAP block as part of multimodal analgesia after cesarean delivery. I also recommend
further study to find out the effect of TAP block after 12 hr
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Keywords
Multimodal Analgesia; Transversus abdominis