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Abstract
Background and aims Caesarean section (C/S) is a commonly performed obstetric procedure causing a somatic pain and a visceral pain. Pain treatment leads to decreased maternal morbidity, early mobilization and increases patient satisfaction. Adding a regional anesthesia technique to multimodal analgesia in C/S, improves the quality of postoperative care. In this study, we evaluated the effectiveness of transversalis fascia plane block (TFPB) first time for postoperative analgesia management in C/S. Although it is an old and practical block currently it was only investigated in a few studies.
Methods The study was approved by the local ethics committee and the study was registered with clinicaltrials.gov (NCT03741452). Following exclusion, patients were randomized equally as block and control group. Standard multimodal analgesia was performed in Group C while TFPB block was also performed in the intervention (TFPB) group. Our primary outcome was to evaluate Tramadol consumption and additional rescue analgesic requirement. Our secondary outcome was to assess pain intensity between groups with numeric rating scores.
Results Seventy-five patients (ASA I-II) were recruited. NRS scores were lower in Group TFPB during the first 3 hours and at the 12th hour. Tramadol consumption at 3rd, 6th and 12th hours and in the first 24 hours was lower in Group TFPB (p<0.01) (figure 1). NRS scores were lower in the block group at 1st, 3rd and 12th hours (p<0.01, p<0.01 and p<0.01 respectively).
Tramadol consumption of patients
Average NRS Scores at rest and on movement/coughing during first 24 hours
Conclusions Bilateral ultrasound guided TFPB is a practical block and leads to effective analgesia and a decrease in analgesia requirement in first 24 hours in patients undergoing CS.