Effectiveness of Transverses Abdominals Plane Block as a Part of Postoperative Analgesia for Post Cesarean Delivery Pain Management: A Prospective Cohort Study

Abstract

Background: Pain after cesarean delivery is experienced through an incision below the umbilicus, which derives from the abdominal wall. As with other patients, these mothers require multimodal pain management that provides high-quality analgesia with minimal side effects. Opioids are widely used to manage pain; however, opioids have adverse effects. TAP block is usually given as a part of postoperative pain management after a cesarian section. Objective: The main aim of this study was to assess the effectiveness of the transversus abdominis plane block when used as a part of postoperative analgesics after cesarean delivery under spinal analgesia at Jimma University Medical Center. Method: An institutional-based prospective cohort study design was conducted from August 2022 to October 2022. The study was conducted on 64 parturients who underwent cesarean delivery under spinal anesthesia. Those who took bilateral traverses abdominis block (n = 32) versus (non-TAP) managed with systemic analgesics alone (n = 32) were followed postoperatively. Data were collected through chart review and postoperative pain was assessed during coughing and at rest by using a visual analog scale at the 2 nd, 4th, 6th , and 12th hours. In addition, postoperative total analgesic consumption and hemodynamic parameters were assessed. Epi-data 4.6 and SPSS version 26 software were used for data entry and analysis, respectively. Result: Postoperative VAS pain scores, both during coughing and at rest, were significantly lowered in the TAP block group compared to the non-TAP group (p < 0.05). Total analgesic consumption was significantly reduced in the TAP block group with a median total Tramadol dose of 50mg compared with 100mg in the control group within 12 hours (P < 0.05). However, no significant differences were found in the postoperative pulse rate, arterial pressure, and nausea/vomiting between the groups (p > 0.05). Conclusion: TAP block reduced postoperative pain and total postoperative analgesics consumption when used as a part of postoperative analgesia for post-cesarean delivery pain control.