An Assessment of Transversus Abdominis Plane Block vs Wound Site Infiltration with 0.25% Ropivacaine for Postoperative Analgesia Post-cesarean Delivery Performed under Subarachnoid Block
Avinash Shastri H, Chethananand TN, Varsha TB, Ankita T Singh
Citation Information :
H AS, TN C, TB V, Singh AT. An Assessment of Transversus Abdominis Plane Block vs Wound Site Infiltration with 0.25% Ropivacaine for Postoperative Analgesia Post-cesarean Delivery Performed under Subarachnoid Block. J South Asian Feder Obs Gynae 2024; 16 (6):658-661.
Background: Optimum postoperative pain management is vital in enhancing recovery and maternal comfort following cesarean delivery. Transversus abdominis plane (TAP) block, a fascial plane block is an effective technique for managing postoperative pain after abdominal surgeries. Wound-site infiltration (WSI) is an established technique for analgesic management. Our research analyzes the pain-relieving effect of this fascial plane block vs WSI following cesarean delivery.
Materials and methods: This trial, a double-blinded randomized study performed at AIMS Hospital, Karnataka over 3 months included 60 parturients posted for elective surgical delivery under subarachnoid block (SAB) who were randomly allocated into: TAP block group A (n = 30) receiving 20 mL of 0.25% of ropivacaine on either side and WSI group B (n = 30) receiving 20 mL of 0.25% ropivacaine infiltrated along the incision. Primary outcome was to note the time to first rescue analgesia demand. Secondary variables evaluated visual analog score (VAS), total first rescue analgesic needed, total number of parturient's needing second rescue pain management in 24 hours following surgery, also sequelae correlated to TAP block and infiltration method.
Results: The average time for initial rescue analgesic in group A is 13.03 ± 1.24 hours, whereas in group B is 3.23 ± 1.072 hours (p = 0.001). The VAS scores at intervals 2, 4, 6, 12, and 24 hours were minimum in group A than in group B. In addition, group A had a considerably minimum analgesic demand in first 24 hours (p < 0.001).
Conclusions: The TAP block with 0.25% ropivacaine provides superior postoperative analgesia compared with WSI in patients undergoing cesarean delivery under SAB. This approach should be used as part of a multimodal pain management for better postoperative recovery and patient comfort.
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