ULTRASOUND-GUIDED TRANSVERSUS ABDOMINIS PLANE BLOCK AS AN EFFECTIVE METHOD FOR POST-CESAREAN PAIN MANAGEMENT IN RURAL AREAS
Ahmed A. Salem
Anesthesia & ICU Department, Faculty of Medicine, Benha University
Background: Inadequate post-cesarean delivery (Post-CS) pain may delay early convalescence and increase the incidence of complications with prolonging hospital stay. Objectives: To compare the efficiency of Ultrasound-guided Transversus Abdominis Plane (USG-TAP) block to intravenous patient-controlled analgesia (IV-PCA) for management of post-cesarean delivery pain in rural areas. Method: One hundred ASA I and II women assigned for CS were divided into USG-TAP block group and IV-PCA morphine group. USG-TAP block was performed using 0.25% isobaric bupivacaine 15-ml on both sides, and IV-PCA morphine group received basal infusion of 1 mg/hr, 1.5 mg bolus with 10-min lockout interval. Outcomes included postoperative (PO) visual analogue scale (VAS) pain scores determination, 24-hr total opioid consumption and frequency of sedation, nausea and vomiting. Result: PO pain VAS scores and frequency of rescue analgesia requests showed non-significant difference between groups. However, the difference in frequency of PO sedation was significantly higher, while frequency of nausea and vomiting was non-significantly different between both groups. Conclusion: In rural areas, for Post-CS pain management, USG-TAP block is an effective method as IV-PCA and relatively safe procedure.