title: Efficacy of ultrasound-guided transversus abdominis plane (TAP) block for postcesarean section delivery analgesia--a double-blind, placebo-controlled, randomized study.
abstract: BACKGROUND
  Ultrasound-guided transversus abdominis plane (TAP) block has been used for intra-operative and postoperative analgesia. Here we evaluate the efficacy of TAP block for postoperative cesarean delivery analgesia.
  
  
  METHODS
  A randomized, double-blind, placebo-controlled trial was performed at King Khalid University Hospital on 40 patients undergoing cesarean delivery under spinal anesthesia with bupivacaine and fentanyl. At the end of surgery they received bilateral ultrasound-guided TAP block either with bupivacaine 0.25% (B group) 20 patients, or saline (S group, or placebo group) 20 patients, followed by patient controlled analgesia with i.v. morphine only. Each patient was assessed 24 hours after delivery for pain, morphine consumption, nausea, vomiting, sedation, patient's satisfaction, and also pain relief during mobilization (24 hours post-cesarean section).
  
  
  RESULTS
  All 40 participants completed the study. Total morphine consumption was reduced more than 60% in the bupivacaine group; the bupivacaine group also reported improved satisfaction with their pain relief over 24 hours after surgery, reduced morphine consumption, less nausea, vomiting, and better patient's satisfaction.
  
  
  CONCLUSIONS
  Ultrasound-guided TAP block improved postoperative analgesia, reduced morphine consumption and improved patient's satisfaction regarding analgesia after cesarean delivery.
authors.affiliation: Department of Anaesthesia, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia. bjumana@yahoo.com
authors.forename: Jumana M
authors.initials: JM
authors.lastname: Baaj
authors.forename: Raed A
authors.initials: RA
authors.lastname: Alsatli
authors.forename: Hayan A
authors.initials: HA
authors.lastname: Majaj
authors.forename: Zainab A
authors.initials: ZA
authors.lastname: Babay
authors.forename: Ahmed K
authors.initials: AK
authors.lastname: Thallaj
mesh_terms: D000009:Abdominal Muscles / Q000000981:diagnostic imaging / Q000187:drug effects; D000328:Adult; D000698:Analgesia / Q000379:methods*; D016058:Analgesia, Patient-Controlled / Q000379:methods; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002045:Bupivacaine / Q000627:therapeutic use*; D002585:Cesarean Section; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D009020:Morphine / Q000627:therapeutic use; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D017060:Patient Satisfaction; D011247:Pregnancy; D012965:Sodium Chloride / Q000008:administration & dosage; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D012965:Sodium Chloride; D009020:Morphine; D002045:Bupivacaine