Efficacy of ultrasound-guided transversus abdominis plane (TAP) block for postcesarean section delivery analgesia--a double-blind, placebo-controlled, randomized study.

BACKGROUND: Ultrasound-guided transversus abdominis plane (TAP) block has been used for intra-operative and postoperative analgesia. Here we evaluate the efficacy of TAP block for postoperative cesarean delivery analgesia.

METHOD: A randomized, double-blind, placebo-controlled trial was performed at King Khalid University Hospital on 40 patients undergoing cesarean delivery under spinal anesthesia with bupivacaine and fentanyl. At the end of surgery they received bilateral ultrasound-guided TAP block either with bupivacaine 0.25% (B group) 20 patients, or saline (S group, or placebo group) 20 patients, followed by patient controlled analgesia with i.v. morphine only. Each patient was assessed 24 hours after delivery for pain, morphine consumption, nausea, vomiting, sedation, patient's satisfaction, and also pain relief during mobilization (24 hours post-cesarean section).

RESULTS: All 40 participants completed the study. Total morphine consumption was reduced more than 60% in the bupivacaine group; the bupivacaine group also reported improved satisfaction with their pain relief over 24 hours after surgery, reduced morphine consumption, less nausea, vomiting, and better patient's satisfaction.

CONCLUSION: Ultrasound-guided TAP block improved postoperative analgesia, reduced morphine consumption and improved patient's satisfaction regarding analgesia after cesarean delivery.