Comparison of analgesic efficiency between wound site infiltration and ultra-sound-guided transversus abdominis plane block after cesarean delivery under spinal anaesthesia.

2014 
BACKGROUND: [corrected] Local anesthetic infiltration applied on the wound site or abdominal wall may be used for relieving postoperative pain after delivery by caesarean section. The aim of this study was to compare the analgesic efficiency of ultrasound (USG)-guided transversus abdominis plane (TAP) block with local anesthetic infiltration on a wound site. METHODS: This study was designed as a prospective randomized trial, and consisted of 70 pregnant women of American Society of Anesthesiologists (ASA) class I-II. Patients were randomized into Group I (wound site infiltration, n=35) and Group T (TAP block, n=35). Spinal anaesthesia was administered to all patients. In Group I, wound site infiltration was applied by the surgical team. In Group T, a USG-guided bilateral TAP block was applied. Patients' numeric pain scale (NPS) levels at 2, 6, 12 and 24(th) hours, after the operation (NPS0) and during mobilization were assessed. Postoperative complications, time to first analgesic request and patient satisfaction were recorded. RESULTS: The NPS0 values of Group T were found to higher and time to first analgesic request longer than those of Group I. The NPS values of Group I at 2, 6, 12, and 24(th) hours were found to be statistically significantly higher than those of Group T. CONCLUSIONS: According to our results, USG-guided TAP block might be superior to infiltration anaesthesia for postoperative pain management of patients who have had caesarean section and it provided longer-lasting and more efficient analgesia.
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