Ceserean Section and Postoperative Pain
Conditions
Keywords
Postoperative Recovery, Cesarean Section, Postoperative Pain, Transversalis Fascia Plane Block, Transversus Abdominis Plane Block, Intrathecal Opioid, ObsQoR-10 T
Brief summary
Cesarean delivery rates are rising globally, and effective postoperative analgesia is crucial for maternal recovery and newborn care. While intrathecal morphine offers strong analgesia, it may cause side effects such as nausea, pruritus, or respiratory depression. The transversus abdominis plane (TAP) block provides somatic pain relief but is often insufficient alone. The transversalis fascia plane block (TFPB) has been shown to enhance lower abdominal analgesia. This study aims to evaluate whether combining TAP and TFP blocks can provide analgesic efficacy comparable to intrathecal morphine in cesarean section patients who are unable to receive opioids or are at high risk of side effects.
Interventions
PROCEDURETransversalis fascia plane block and transversus abdominis plane block
20 ml local anesthetics for Transversus Abdominis Plane block and 10 ml local anesthetics for Trasnversalis fascia plane block
PROCEDUREIntrathecal Morphine
100 mcg morphine with local anesthetics injected intrathecally
Sponsors
Ataturk University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 45 Years
Healthy volunteers
Yes
Inclusion criteria
* 18-45 years old * American Society of Anesthesiologists physical score I or II * caesarean section with a Pfannenstiel incision
Exclusion criteria
* additional surgical intervention, or received general anaesthesia, * hypersensitivity to the agents to be used * BMI greater than 35 kg m-2 * coagulopathy, * local infection, * opioid addiction, * pregnancy-related hypertension * diabetes mellitus
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The Obstetric Quality of Recovery-10 (ObsQoR-10) Score | Postoperative 24 hours | The questionnaire's subscales are physical comfort (n=3 items), emotional state (n=2 items), pain (n=1 item), physical independence (n=2 items), and the ability to take care of the newborn (n=2 items). Each item is scored on a scale of 0-10, except for the first four items, which are graduated from 10 to 0. The total score is the sum of all item scores (i.e. a score ranging from 0 to 100, where 0 is the worst recovery score, and 100 indicates the best). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Opioid consumption | Postoperative 24. hours | Patient controlled analgesia based opioid requirement |
Countries
Turkey (Türkiye)
Outcome results
None listed