DIRECT VISUALIZATION TRANSVERSUS ABDOMINIS PLANE (DV-TAP) BLOCK - A NEW APPROACH FOR POST-OPERATIVE PAIN CONTROL IN PATIENTS UNDERGOING LOWER SEGMENT CAESAREAN SECTION
Mohamed A. Elsenity1, Marwa M. Mowafi2
1Obstetrics and Gynecology Department Ain shams university
2Anesthesia Department Ain shams university
Background The management of postoperative pain is paramount to facilitate the delivery of day case surgical programs. The aim of this study was to evaluate if the women receiving TAP blocks require less opioid in the first 24hours. Study design: A prospective, randomized, double-blinded trial was conducted with patients undergoing lower segment caesarean section under spinal anesthesia. Patients were randomized to study group that received Direct Visualization Transversus Abdominis Plane (DV-TAP) Block with intrathecal hyperbaric bupivacaine 0.5% (12.5–15 mg) and a control group underwent lower segment caesarean section under spinal anesthesia with routine postoperative analgesic care but without TAP block. All patients received 100mg ketoprofen rectally and prescribed regular oral diclofenac potassium (50 mg every 8 hours) and paracetamol (1 g every 6 hours). Postoperative pain scores were recorded using numerical rating scores. Results: A total of 40 eligible women planned to undergo elective LSCS were recruited in the current trial, and were randomly allocated into one of the two groups, There were no significant differences between women of both groups regarding the age, parity or BMI. The median time to first request, the median total 24-hour-postoperative pethidine dose and the proportion of women who had moderate/severe pain 6-9 hours postoperatively were all significantly lower among women of group I when compared to women of group II.