title: Ultrasound-guided transversus abdominis plane block for post-operative analgesia in patients undergoing caesarean section.
abstract: OBJECTIVE
  Transversus abdominis plane (TAP) block is a fascial plane block providing post-operative analgesia in patients undergoing surgery with infra-umbilical incisions. We evaluated analgesic efficacy of TAP block with ropivacaine for 24 h after caesarean section through a Pfannenstiel incision.
  
  
  METHODS
  Sixty patients undergoing caesarean section under spinal anaesthesia were randomised to undergo TAP block with ropivacaine (n = 30) versus control group (n = 30) with normal saline, in addition to standard analgesia with intravenous paracetamol and tramadol. At the end of the surgery, ultrasound-guided TAP plane block was given bilaterally using ropivacaine or normal saline (15 ml on either side). Each patient was assessed post-operatively by a blinded investigator at regular intervals up to 24 h for visual analogue score (VAS) and requirement of analgesia. SPSS version 18.0 software was used. Demographic data were analysed using Student's t-test and the other parameters using paired t-test.
  
  
  RESULTS
  TAP block with ropivacaine compared with normal saline reduced post-operative VAS at 24 h (P = 0.004918). Time for rescue analgesia in the study group was prolonged from 4.1 to 9.53 h (P = 0.01631). Mean requirement of tramadol in the first 24 h was reduced in the study group.
  
  
  CONCLUSIONS
  US guided TAP block after caesarean section reduces the analgesic requirement in the first 24 h.
authors.affiliation: Department of Anaesthesiology, Smt. Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India.
authors.forename: Maitreyi Gajanan
authors.initials: MG
authors.lastname: Mankikar
authors.affiliation: Department of Anaesthesiology, Smt. Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India.
authors.forename: Shalini Pravin
authors.initials: SP
authors.lastname: Sardesai
authors.affiliation: Department of Anaesthesiology, Smt. Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India.
authors.forename: Poonam Sachin
authors.initials: PS
authors.lastname: Ghodki
keywords: Caesarean section; multimodal analgesia; ropivacaine; transversus abdominis plane block