Background and Aims Modulation of mRNA expression ofOXTRgene following the use of ultrasound-guided transversals fascia plane block when compared with wound infiltration for post-cesarean pain management for prevention of chronic persistent post-surgical pain (CPSP).
Methods The present randomized, controlled study was conducted following IEC- Human approval, prospective CTRI registration and written informed consent from participants. All patients of ASA-I and I undergoing cesarean delivery(CD) under SAB were included. Patients were randomized into two groups, patients in group C received standard wound infiltration using 20 ml of 0.375% ropivacaine and patients in group-T, received bilateral ultrasound-guided Transversalis fascia plane block using 20 ml of 0.375% ropivacaine at the end of the surgery. OXTR gene expression was done as per standard protocol from the samples withdrawn at baseline and at the end of 14th week. Un-paired student t-test, Mann-Whitney U test and Pearson correlation were used.
Results Finally, 60 patients with 30 patients in each group were included. The mean delta Ct of OXTRgene expression at baseline was comparable between the two groups; however, upregulated in group T at 14’ week i.e. 2.41+0.72 vs 1.61+0.84. Similarly, the fold changes of OXTRgene expression in test group at the end of 14th week was higher i.e. 7.44 vs 4.35. A significant positive correlation was observed between theOXTR gene expression and pain intensity at 14th week.
Conclusions A significant up-regulation ofOXTRgene and its significant positive correlation with pain intensity following TFPB validates the efficacy of TFPB for prevention of CPSP following cesarean delivery.
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