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ULTRASOUND-GUIDED TRANSVERSES ABDOMINIS PLANE BLOCK VERSUS EPIDURAL TECHNIQUE AS REGARD IMPACT OF MULTI MODAL ANALGESIA ON POSTOPERATIVE QUALITY OF RECOVERY AFTER CESAREAN SECTION
ESRA Academy. Sherif A. Sep 8, 2016; 138375
Topic: Obstetric Population
Prof. Dr. Abeer Sherif
Prof. Dr. Abeer Sherif

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Abstract
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Background and Aims:

Post-cesarean section analgesia is complicated because; parturient dislike motor impairment, and many analgesics are excreted in breast milk(1). Epidural analgesia is highly effective to control postoperative pain, but significant concerns still exist regarding; residual motor blocks, need for early ambulation, and cost. (2). Ultrasound-guided transverses abdominis plane (TAP) is a relatively simple technique, which has shown to be effective analgesic modality when used as a part of multi modal analgesia. In the present study the effectiveness of TAP block was compared to epidural analgesia as a part of multi modal regimen of pain control.

Methods:

00 patients underwent cesarean section were randomized into two groups 100 patients each. Group A (TAP block) received spinal anesthesia followed by bilateral TAP block at the end of the surgery and before extubation. Group B (epidural analgesia) all patients received combined spinal epidural. The primary outcome was the global quality of recovery-40-question-air at 24 hours after surgery. The secondary outcome included time to first analgesia, pain scores, and morphine consumption.

Results:

Patients in group (A), showed better quality of recovery scores in all the Q-R-40 sub components that was statistically significant in comparison to group (B) patients. No patients on group (A) had motor block, while 45% of patients on group (B) reported mild to moderate motor block.

Conclusions:

TAP block considered to be simple and valuable alternative to epidural analgesia, it seems to be a promising opportunity for parturient, that provide better quality of postoperative recovery, without motor block. 

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