Clinical effectiveness of Intra-operative direct vision of transversus abdominis plane (TAP) block as alternative to ultrasound guided TAP block for pain control after cesarean section (CS) A randomized Controlled Trial

doi:10.21608/aimj.2025.396620.2572

Clinical effectiveness of Intra-operative direct vision of transversus abdominis plane (TAP) block as alternative to ultrasound guided TAP block for pain control after cesarean section (CS) A randomized Controlled Trial

Document Type : Original Article

10.21608/aimj.2025.396620.2572

Abstract

Background: Despite their efficacy, opioids prescribed after CS may result in significant side effects, as nausea, sleepiness, respiratory depression, and potential risks to newborns through breastfeeding.
Objective: To evaluate the analgesic efficacy of USG-TAP block versus intraoperative transversus abdominis block during and after CS, focusing on pain scores within twenty-four hours post-surgery in females.
Patients and Methods: Two hundred pregnant females who underwent elective cesarean sections were enrolled in this trial, with one hundred receiving intraoperative direct vision TAP blocks and one hundred receiving ultrasound-guided TAP blocks. All cases underwent intrathecal anesthesia via dural puncture at the L3-L4 level, receiving 0.25 percent hyperbaric bupivacaine, followed by a standardized surgical approach for cesarean birth.
Results: The Visual Analogue Scale (VAS) was a standardized ten cm laminated card, on which participant indicated or verbalized a number that most accurately reflects their experience. Analgesic usage was documented from the cases' medication records. Recorded, tabulated, and statistically evaluated data indicated that surgically administered TAP block provided comparable benefits, pain management outcomes post-CS to UG-guided TAP. Additionally, there was a corresponding decrease in the necessity for both opioid and non-opioid analgesics, accompanied by a notable postponement of initial requests for such medications.
Conclusion: Both ultrasound-guided , surgical TAP blocks were safe , similarly effective after cesarean section. surgical TAP block is a fast, safe alternative, especially for obese patients or when ultrasound is unavailable.

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