Ultrasound Guided Transversus Abdominis Plane Block Versus Single dose Epidural Morphine as A postoperative Analgesia after Elective Cesarean Section

Background: Postoperative pain management following cesarean delivery under spinal anaestheia requires a number of procedures, systemic and/or intrathecal opioids, such as bilateral erector spinae plane (ESP) block and the transversus abdominis plane (TAP) block with parenteral analgesics. This study aimed to compare between ultrasound guided transversus abdominal plane (TAP) block and single dose epidural morphine on post-operative pain and analgesic requirement in parturients undergoing elective cesarean delivery. Methods: This prospective randomized clinical study was conducted over the period of one year. This study comprised 64 patients who were induced spinal anesthesia and randomly assigned to two equal groups : group T ( 32 cases who received TAP block after skin closure ) and group E (the remaining 32 cases who underwent epidural analgesia with a single dose of 4 mg morphine given in epidural space) all cases were submitted to a detailed history, physical examination, and regular laboratory investigation. Results: Although the two groups expressed comparable scores during the first 3 hours after operation, but the TAP group reported reduced pain scores in later measurements. The timing of first analgesic request increased significantly in the TAP group. The required extra morphine dose increased significantly in the epidural group. The epidural group experienced much more nausea, vomiting, pruritis, and shivering. Conclusion: In TAP block group, the lower postoperative numeric rating scores (NRS) measured in all time points, the lower amount of intravenous analgesics given to the patients in the postoperative period and high level of patient satisfaction of TAP block thechnique.