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A comparison Between the Transversus Abdominis Plane (TAP) Block Versus Traditional Parentral Analgesia Post Caesarian Section

Authors: Iyad Abbas Salman --- Hayder Saad Kamel
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: supplement Pages: 718-723
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Postoperative pain, especially when poorly controlled, results in harmful acute effects (i.e., adverse physiologic responses) and chronic effects (i.e., delayed long-term recovery and chronic pain).The transversus abdominis plane (TAP) block is a new method of providing postoperative analgesia in patients undergoing lower abdominal wall incisionsOBJECTIVE:To compare the effectiveness of TAP block versus traditional parenteral analgesia post caesarian section.PATIENTS AND METHODS:A prospective randomized double blinded placebo controlled clinical trial conducted in the department of obstetrics & gynecology of medical city complex. over a period of four months from 1st of November to 1st of march. Fifty women patients were selected to be enrolled in this study who were scheduled for C.S. via pfannenstiel incision, all patients were of ASA I- II physical status. Twenty five of them were given TAP block with (bupivacaine 0.25%) & placebo i.v saline (0.9%) , the other twenty five were given i.v tramadol & i.m diclofinac sodium & placebo TAP block with normal saline 0.9%.Numerical rating scale was used to follow up the patients postoperatively at 2,6,12,16 hours.RESULTS :By comparing the means of numerical analogue scale score over the time there was a significant difference in mean score over the time, the traditional treatment had better effect on relieving pain only at the 1st 2 hours where TAP block was better on the rest time with a highly significant difference P.value < 0.05 in all comparisons.CONCLUSION:TAP block is not effective as sole analgesic, but is effective in reducing the frequency of doses of incremental analgesia. TAP block is more effective than traditional analgesia in reducing the mean of pain score .The traditional parentral analgesia require more frequent dosing.

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