Assessment of analogous analgesic efficacy of transversus abdominis plane block by land mark technique after Cesarean Sections in rural population.

Dr. Bindiya Salunke; Dr. Nambiraj Konar; Dr. Sachin Dongarwar

Volume : VII, Issue : VI, June - 2017

Assessment of analogous analgesic efficacy of transversus abdominis plane block by land mark technique after Cesarean Sections in rural population.

Dr. Bindiya Salunke, Dr. Nambiraj Konar, Dr. Sachin Dongarwar

Abstract :

Introduction: Women who have cesarean sections anticipate substantial pain and discomfort. They need to be mobile and observant early to cater to the needs of their newborn child. Traditionally, systemic drugs were used as adjutants to spinal, epidural or general anesthesia. Blocking the peripheral nerves is an alternative means of providing analgesia and thus reduce the need of systemic drugs and their dose related side effects. The purpose of this article was to determine the corresponding analgesic efficacy of transversus abdominis plane (TAP) block by landmark technique after Cesarean Sections (CS). Methodology: A randomized, double–blind, trial was performed at B.K.L. Walawalkar hospital, Dervan. 40 female parturient of ASA physical status I or II for cesarean section under spinal anaesthesia, were randomized to have a bilateral TAP block with 0.25% Ropivacaine (Group A = 20 ) or to undergo no block (Group B = 20) These patients in addition received standard analgesic comprising 75 mg Diclofenac 8 hourly. Each patient was assessed at 0, 2, 4, 6, 8, 12, 18 and 24 hours after surgery by an independent observer for pain using visual analogue scale (VAS), total analgesic consumption and time for the first rescue analgesic request. Rescue analgesia in the form of Tramadol 50 mg IV was given to patients on demand or when VAS was more than 4. Results: The mean VAS score was significantly decreased in Group A (TAP block with 0.25% Ropivacaine) as compared to group B (no block). Time to first analgesic administration (Tramadol) was prolonged significantly in Group A (mean 18 hours) as compared to Group B (mean 8.67 hours), P <0.001. In patients receiving TAP block with 0.25% Ropivacaine (Group A), the requirement for analgesic significantly reduced as compared to those who did not receive the block (Group B) P <0.001 Conclusion: TAP block (by land mark technique) improved postoperative analgesia, reduced Tramadol consumption and prolonged the time for first rescue analgesic request after cesarean section.