Comparison between Transversus Abdominis Plane Block and Rectus Sheath Block on Postoperative Pain in Lower Abdominal Surgeries

Background: Many major lower abdomen operations cause significant pain and discomfort after the procedure. If postoperative pain is not addressed right once, it may hinder the patient's mobility, increasing the risk of serious complications. For these patients, a multimodal postoperative pain management program that offers superior analgesia with few adverse effects is necessary. Objective: To compare the effect of postoperative transversus abdominis plane (TAP) block versus postoperative RS block on postoperative pain, analgesic requirements and hemodynamic changes after lower abdominal surgeries. Patients and Methods: This study was conducted in Ain Shams University Hospitals, Egypt. 30 patients were randomly divided into 2 groups: Group A: Transversus abdominis plane (TAP) Group (15 Patients), and Group B: Rectus sheath (RS) Group (15 Patients). Results: The TAP block (Group A) resulted in a more stable hemodynamic profile, with consistently higher mean arterial pressure (MAP) across all time points compared to the RS block (Group B). Additionally, 53.3% of the TAP group required the first morphine dose, significantly lower than 86.7% in the RS group, with the TAP group needing lower initial doses. These results imply that although both blocks work well, the TAP block may offer more consistent early postoperative pain control and reduce initial opioid requirements, whereas the RS block may be more beneficial later in the recovery period. Conclusion: The comparison between TAP block and RS block for postoperative pain management in lower abdominal surgeries demonstrates that the TAP block provides superior initial pain relief, as evidenced by significantly lower immediate morphine requirements and lower MAP readings, indicating better hemodynamic stability.