Comparative Study between Bupivacaine 0.5% in TAP Block versus Diclophenac Sodium IM for Post-operative Analgesia after Cesarean Section

Abstract

Background: Cesarean section is one of the commonly performed surgical procedures in the field of obstetrics. It accounts for more than one-fourth of all births worldwide. The most common undesirable outcome following cesarean section is postoperative pain. Failure to treat the pain not only causes distress to the mother but also affects mother‑baby bonding, which, in turn, affects care and breastfeeding of the newborn. Objective: The aim of the study is to compare the effectiveness of US guided TAP block using 0.5% bupivacaine versus declophinac sodium for postoperative analgesia in patients undergoing cesearean section and reducing nalufine dose. Methods: This prospective study was conducted at tertiary care hospital at Ain Shams University hospitals for 6 months from June to December 2020 and performed on total 80 patients who underwent elective cesarean section. Results: Our research study revealed that there was statistically significant increase in visual analogue score in diclofenac group than TAP block group explained by removal of effect of spinal anaesthesia and regaining of pain sensation in diclofenac group while persistence of anaesthetic effect of bupivacaine in TAP block group. Our study found that there was statistically significant increase in the time to first request of analgesia in TAP block group than diclofenac group. Also, there was statistically significant decrease in the total consumption of Pethidine (mg) in TAP block group than Diclofenac group. There was no statistically significant difference between Diclofenac group & TAP block group regarding adverse effects post operative nausea & vomiting. Conclusion: The analgesic efficacy of the US-guided TAP block after Caesarean delivery compared to the combination of sodium diclofenac with less requirement of rescue analgesic.