Effect of transverses abdominis block and subcutaneous wound infiltration on post-operative pain analgesia after cesarean section at Hawassa University, southern Ethiopia : A prospective cohort study

Background: post-cesarean section analgesia regime should be efficacious without influencing the ability of a mother to take care of the neonate and with minimal drug transfer through breast milk. Transverse abdominis plane block and local anesthetic wound infiltration can provide effective pain relief at the wound site after surgery. However, the relative efficacy of two techniques for postoperative analgesia remains controversial. Objective: This study aimed to compare the analgesic efficacy of Transverse abdominis plane block versus subcutaneous wound infiltration as part of for elective cesarean section surgeries under spinal anesthesia. Materials and methods: An institutional-based Prospective cohort study was employed two equal groups of 68 adult females aged 18–65 years scheduled for elective cesarean under spinal anesthesia and wound infiltration a non-exposed group. Pain severity, first analgesia request time as well as analgesic consumption were assessed using the Mann –Whitney U test for 24 h. Chi-square test was used to analyze the homogenous categorical independent variables between these two groups and a p-value less than 0.05 was considered as statistically significant. Result: The overall Tramadol consumption within 24 h with The Median and IQR was 100 mg (100–150) in the TAP group compared to 150 mg (150–200) in the subcutaneous wound infiltration group (p < 0.001). We conclude that TAP block could be considered Superior to subcutaneous wound infiltration anesthesia for postoperative pain management and we recommend that use of TAP block for effective Postoperative analgesia as part of multimodal analgesia after cesarean section with spinal anesthesia. We recommend the clinicians to use Tap for postoperative pain management.