Comparison of the Effectiveness of Ultrasound-guided Transversalis Fascia Plane Block (TFPB) and Transversus Abdominis Plane Block (TAPB) on Postoperative Pain in Caesarean Section: A Prospective Randomized Study

Abstract

Objective:Postoperative peripheral trunk blocks are used for multimodal analgesia in caesarean sections. This trial was planned to compare the efficacy of transversalis fascia plane block (TFPB) and transversus abdominis plane block (TAPB) in postoperative analgesia in patients undergoing caesarean section under spinal anaesthesia.Method:In this prospective trial, ASA II-III risk group patients between the ages of 20-50 years who were scheduled for elective caesarean section under spinal anaesthesia were evaluated. Demographic data, duration of operation, presence of intraoperative and postoperative nausea & vomiting, pruritus, duration of first analgesia requirement, visual analogue scale (VAS) values for 24 hours postoperatively, paracetamol, diclofenac sodium, the total amount of non-steroidal anti-inflammatory drugs (NSAIDs) used were recorded.Results:Patients were randomized into two groups: TFPB (75, 50%) and TAPB (75, 50%) groups. There was no significant difference in demographic data, comorbidity, ASA classification and operation times between the two groups (p>0.05). When the duration of the first postoperative analgesia requirement was evaluated, it was higher in the TFPB group (p<0.05). The 24-hour pain scores (VAS 6th hour and VAS 12th hour) were lower in the TFPB group (p<0.05). The amounts of paracetamol, diclofenac and total NSAIDs were higher in the TAPB group (p<0.05).Conclusion:USG-guided bilateral TFPB is more effective than TABP for postoperative analgesia in caesarean sections.

Keywords

• caesarean section
• nerve block
• obstetrical anesthesia
• postoperative pain
• spinal anaesthesia