title: Efficacy of trans abdominis plane block for post cesarean delivery analgesia: A double-blind, randomized trial.
abstract: BACKGROUND
  The transverse abdominis plane (TAP) block, a regional block provides effective analgesia after lower abdominal surgeries if used as part of multimodal analgesia. In this prospective, randomized double-blind study, we determined the efficacy of TAP block in patients undergoing cesarean section.
  
  
  METHODS
  Totally, 62 parturients undergoing cesarean section were randomized in a double-blind manner to receive either bilateral TAP block at the end of surgery with 20 ml of 0.25% bupivacaine or no TAP block, in addition to standard analgesic comprising 75 mg diclofenac 8 hourly and intravenous patient-controlled analgesia (PCA) tramadol. Each patient was assessed at 0, 4, 8, 12, 24, 36, and 48 h after surgery by an independent observer for pain at rest and on movement using numeric rating scale of 0-10, time of 1(st) demand for tramadol, total consumption of PCA tramadol, satisfaction with pain management and side effects.
  
  
  RESULTS
  Use of tramadol was reduced in patients given TAP block by 50% compared to patients given no block during 48 h after surgery (P < 0.001). Pain scores were lower both on rest and activity at each time point for 24 h in study group (P < 0.001), time of first analgesia was significantly longer, satisfaction was higher, and side effects were less in study group compared to control group.
  
  
  CONCLUSIONS
  Transverse abdominis plane block was effective in providing analgesia with a substantial reduction in tramadol use during 48 h after cesarean section when used as adjunctive to standard analgesia.
authors.affiliation: Department of Anesthesiology and Critical Care, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.
authors.forename: Uma
authors.initials: U
authors.lastname: Srivastava
authors.affiliation: Department of Anesthesiology and Critical Care, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.
authors.forename: Shilpi
authors.initials: S
authors.lastname: Verma
authors.affiliation: Department of Anesthesiology and Critical Care, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.
authors.forename: Tapas Kumar
authors.initials: TK
authors.lastname: Singh
authors.affiliation: Department of Anesthesiology and Critical Care, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.
authors.forename: Amrita
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Department of Surgery, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.
authors.forename: Avanish
authors.initials: A
authors.lastname: Saxsena
authors.affiliation: Department of Anesthesiology and Critical Care, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.
authors.forename: Keshav Dev
authors.initials: KD
authors.lastname: Jagar
authors.affiliation: Department of Anesthesiology and Critical Care, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.
authors.forename: Mihir
authors.initials: M
authors.lastname: Gupta
keywords: Bupivacaine; cesarean section; transverse abdominis plane block