Cesarean Section Complications, Post Operative Pain
Conditions
Keywords
TAP block, C-section, Spinal anesthesia, localized field effects, analgesia, Postoperative pain and Opioids
Brief summary
Transverse abdominis plane (TAP) block is an effective method to manage postoperative pain in patients with midline abdominal wall incisions. It is used frequently in many lower abdominal surgeries however its use after caesarean section is still new, and fewer studies are available. We conducted this study to see the analgesic effect of TAP block after caesarean section.
Detailed description
The study is being conducted, at Combined Military Hospital Sargodha, Pakistan, to compare the analgesic efficacy of TAP block in providing post-caesarean analgesia with the control group, in terms of mean postoperative use of opioids after caesarean delivery. Sixty patients have been randomly selected using non-probability, consecutive sampling, and applying inclusion and exclusion criteria. The study design is a randomized controlled trial with thirty patients in each group undergoing elective caesareans. All patients will be given spinal anaesthesia with 1.5ml of 0.75% hyperbaric bupivacaine for a caesarean section. Patients in Group A will receive bilateral TAP block with 20ml of 0.25% bupivacaine while 20 ml of saline will be injected in patients of Group B on both sides of midline after caesarean section, in addition to intravenous ketorolac 8hrly. The intensity of pain, total opioid consumption, presence of vomiting, and sedation will be noted until 24 hours after the surgery.
Interventions
PROCEDURETrans abdominis plane block
Ultrasound guided infiltration of local anaesthetic bupivacaine via 22G Quincke needle between internal oblique and trans abdominis muscle layers in abdominal wall.
Sponsors
Armed Forces Hospital, Pakistan
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
20 Years to 45 Years
Healthy volunteers
Yes
Inclusion criteria
* Elective Caesarean section * ASA 1-3 * 20yrs to 45yrs
Exclusion criteria
* Emergency Surgery * known allergy to local anaesthetic * severe pre-eclampsia * placenta accreta * ASA 4 * Coagulopathy * Hemodynamically unstable
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative opioid consumption | 24 hours post cesarean section | within 24hours after surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain intensity Score | from end of secarean section till 24 post operative hours | Pain intensity at 6 hours,12 hours and 24 hours after surgery |
| Vomiting | Within 24hours after surgery | frequency of vomiting within 24hours after surgery |
| Duration of First Rescue Analgesia | Within 24hours after surgery | time after surgery when first dose of opioid required |
Countries
Pakistan
Outcome results
None listed