WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

Dr. Dhiaa Mohammad Jabbar*, Dr. Ali Nima Hassan and Dr. Murtadha Salim Kadhim

ABSTRACT

Background: Around the world, cesarean sections (CS) are among the most common surgical procedures. Pain after a cesarean section is expected. A primary source of pain following a cesarean section is the incision formed in the abdominal wall. Parenteral self-administering drugs (PCA) and regional afferent nerve block (TAP block) are two effective modes that have recently gained popularity to control this pain. Aim of the study: to assess the impact of two different methods for postoperative analgesia (TAP) block and patient control analgesia (PCA) with IV fentanyl after an elective cesarean section under spinal anesthesia on a patient’s pain efficacy and safety. Methods: This randomized controlled research was comprised of sixty women having a cesarean section under spinal anesthesia. They were split into two equal groups: the IV fentanyl PCA group and the TAP block group. After the surgery, while the patient was in the recovery room, the TAP block group received a total of 20 ml diluted 0.25% bupivacaine for each side (we mixed 10 ml of 0.5% isobaric bupivacaine with 10 ml of normal saline). The IV fentanyl PCA group receives an initial dose of 1 mcg/kg and then boluses of 20 mcg at a lock-time of 8 minutes. Postoperatively, mean arterial pressure, heart rate, oxygen saturation, nausea and vomiting, sedation, and visual analogue score were noted over 24 hours (at 0h, 1h, 2h, 4h, 6h, 12h, and 24h). ANOVA and the Chi-square test were used for statistical analysis. Result: Patients who received TAP block had prolonged analgesia; the mean time for rescue analgesia was 12±5 hours, and 6.5±2 hours for both the TAP block group and IV fentanyl PCA group respectively. The pain score was also lower in the TAP block group compared to the IV fentanyl PCA group. Nausea & vomiting scores and sedation scores were lower in the TAP group compared to the IV fentanyl PCA group. Conclusion: An ultrasound-guided TAP block is a more important and safe approach to provide postoperative analgesia to cesarean section under spinal anesthesia than IV PCA with fentanyl.