An Audit to Pain Management of Lower Segmental Caesarean Section in a Tertiary Care Hospital

Women undergoing caesarean delivery present a unique set of challenges to the anesthesiologist in terms of postoperative pain management. The transversus abdominis plane block is an effective method of providing postoperative analgesia in patients undergoing abdominal wall incisions. Accordingly, this retrospective study was conducted and analyzed.

Patients who underwent elective lower segment caesarean section under sub arachnoid block in last 3 months were scrutinized and 100 eligible records found. Categories into who received the transversus abdominis plane block (TAP Group) at the end of surgery and another was who did not receive the TAP block (Control group).

From control group 26 patients complained of pain during first 4 hours, 43 during 8 hours and all 50 complained of pain within 12 hours. Similarly in TAP group 4 patients had complained of pain during first 4 hours, 16 within 8 hours, 29 within 12 hours, 42 within 16 hours. In TAP group 46 patients required rescue analgesics twice or less and 4 required thrice but none of them demanded more than three times whereas in the control group 7 patients demanded twice, 36 demanded three times and 7 of them demanded four times. The ‘p’ value < 0.01 was found to be statistically significant between all the groups.

TAP block is easy to perform under ultrasound guidance with minimal complications and side effects and it provides effective analgesia and holds good as part of a multimodal analgesia regime for patients undergoing lower segment caesarean section.