الفهرس | Only 14 pages are availabe for public view |
Abstract Objectives: comparing between transperitoneal guided TAP block versus ultrasound guided TAP block. As regard of, time of first call of analgesia, patient satisfaction, the amount of additional analgesic needed for 24 hour postoperatively, duration of the procedure and complications encountered in each procedure. Background: Pain after cesarean section is usually described as moderate to severe by most patients. Transverse abdominis plane (TAP) block is a recently introduced regional technique that provide analgesia to the anterior abdominal wall, which is administered under ultrasound guidance or by transperitoneal surgical technique. Material and Methods: Randomized, controlled, double blind study on 70 women who underwent elective caesarean section distributed into two groups each is 35 women. group STB: transperitoneal guided TAP block was given after closing the uterus and establishing hemostasis. group UTB: Ultrasound guided TAP block was done after closure of skin. Results: The patients’ demographic and clinical characteristics were matched between the two studied groups (P>0.05). Block procedure duration (minutes) was shorter in Trans peritoneal TAP block group (p<0.001). In a study comparing pain perception (VAS-10) between two groups (surgical TAP and ultrasound-guided TAP block), there was no significant difference between the groups at any of the measured time points (2, 4, 8, 12, and 24 hours post-operation). Also, no significant differences between the studied groups regarding changes in the postoperative mean of VAS scores at 4, 8, 12, 24 h from the baseline VAS score (at PO-2h). Summary 84 Our study found no significant difference between the two groups in regards to postoperative Opioid analgesia (pethidine) requirements and timing. Both groups had similar percentages (20% and 14.3%) of patients requiring analgesia, with similar number of requests (71.4% and 80.6%) and mean dose (64.3 mg and 60 mg). Additionally, there was no significant difference in the time to first requirement of analgesia (9.1 hours vs 9.6 hours). Our study show a similar level of satisfaction among both groups. 68.6% of patients in the surgical TAP group reported good satisfaction, while 62.9% of patients in the ultrasound-guided TAP block group reported good satisfaction, 31.4% of patients in the surgical TAP group reported Excellent satisfaction, while 37.1% of patients in the ultrasoundguided TAP block group reported Excellent satisfaction. Finally, the results showed that side effects were rare in both the surgical TAP group and the ultrasound-guided TAP block group. Nausea was only reported in 2.9% of the surgical TAP group, with no reports in the ultrasound-guided TAP block group. No cases of vomiting, sedation, respiratory depression, transient femoral nerve palsy, bowel haematoma or local anaesthetics toxicity were reported in either group. Conclusion: USG and surgical TAP blocks were safe and had similar efficacy in providing post-operative analgesia in pregnant women following cesarean section under spinal analgesia. Surgical TAP block is an efficacious, safe and rapid technique, particularly in patients in whom sensory blockade is technically challenging, and does not require additional equipment. |