Background and aims The international literature is unclear regarding the analgesic efficacy of the transversus abdominis plane block (TAPB) after C-section. We aimed to compare analgesic efficacy and postoperative pain localization of TAPB versus regular postoperative analgesia (RPA) after C-section.

Methods A prospective survey study on different analgesia methods after C-section was conducted at Vilnius University Hospital Santaros Klinikos. Randomized assignment to TAPB or RPA was performed. TAPB was performed by administering 150 mg of ropivacaine. Analgesic efficacy using VAS pain scores, adverse events and postoperative pain localization were measured following 24-hours and 48-hours after delivery.

Results 53 women, mean age 31.98±4.44 years, participated in the study. 84.9% and 15.1% women underwent spinal and epidural anaesthesia, respectively. 11 (20.8%) patients were randomly assigned to TAPB group, while RPA analgesia was performed to 42 (79.2%) women. VAS pain scores on movement were statistically significantly lower in the TAPB group compared to RPA patients following 24-hours after C-section (5.54;7.14, p=0.016). VAS pain scores at rest were statistically significantly lower in the TAPB group compared to patients who received RPA following 48-hours after C-section (1.55;3.19, p=0.007). Adverse events, including nausea, back pain, headaches, pruritus, urinary retention, diarrhoea, tremble, cumulative postoperative doses and pain localization did not differ between groups.

Conclusions TAPB can provide an effective analgesia in women undergoing C-section. TAPB was superior to RPA by providing lower VAS pain scores on movement and at rest following 24hours and 48 hours after C-section. TAPB was non-inferior to RPA regarding adverse events, cumulative postoperative doses of analgesics and pain localization.