The effectiveness of transverse abdominis plane (tap) block in reducing the need for postop analgesics after c-section under spinal anesthesia: a randomised control trial

A significant number of women who have caesarean section experiences moderate-to-severe postoperative pain especially around 6 hours after delivery. Transversus abdominis plane (TAP) block is a regional anesthesia technique in which a local anesthetic is injected into the transversus abdominis (TA) planeAim of the study is to determine the effectiveness of transverse abdominis plane (tap) block in reducing the amount of analgesics required during the first 48 hours after c-section under spinal anesthesia.

Investigator and patient blinded randomized control trial. The sample size for the present study was calculated to be 44. All eligible patients undergoing caesarean section delivery under spinal anaesthesia at will be included after taking informed consent.Patients will be classified into two groups using block randomization.

Group A :  TAP block will be done using USG guidance.  Postoperative analgesia will be provided with IV DICLOFENAC( 50 mg IV) q8h and PARACETAMOL 1000  mg q8h. Rescue doses with analgesics will be allowed (TRAMADOL 50 mg) when VAS score is >4

Group B: Standard systemic intravenous postoperative analgesia IV DICLOFENAC( 50 mg IV) q8h and PARACETAMOL 1000  mg q8h will be given. Rescue doses with analgesics will be allowed (TRAMADOL 50 mg) when VAS score is >4.

Result values will be recorded using a proforma. Visual analogue scale needs to be recorded immediately on shifting to recovery and then at 2hr, 6 hr, 12 hr, 24 hr, and 48 hr both at rest and during voluntary contraction of abdominal muscles. Time at which first rescue analgesic is given to be noted. Requirement of rescue analgesics in the first 48 hrs postoperatively and presence of PONV and drowsiness is also assessed.