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1 PB
DOI: 10.5603/GP.a2018.0072
22nd Chair and Clinic of Gynecology and Obstetrics, Jan Mikulicz-Radecki University Teaching Hospital in Wrocław, Poland
ABSTRACT
Objectives: The ultrasound-guided transversus abdominis plane (TAP) block is a supporting method of pain relief after
different types of surgical and gynecological procedures. The aim of the present study was to evaluate the analgesic effects
of the TAP-block in patients undergoing caesarean section.
Material and methods: 88 women undergoing elective caesarean section under spinal anaesthesia were prospectively
randomized into two groups. In the first group, an ultrasound-guided bilateral TAP block was performed using 40 mL 0.25%
bupivacaine, while the second group was treated without a regional nerve block. Both groups received a standard analgesia
protocol with intravenous paracetamol administered every 6 hours and intravenous tramadol on-demand, delivered using
the Patient Controlled Analgesia (PCA) method. Pain intensity was assessed according to the visual analogue scale (VAS)
directly after the TAP block and at 3, 6 and 12 hours postoperatively. Any patient complaints and side-effects during the
postoperative period were recorded.
Results: The TAP block resulted in a significant reduction of pain intensity using the visual analogue scale after 3, 6 and
12 hours (p < 0.05) and a significant decrease in tramadol administration (p < 0.05) during the first 12 hours postoperatively.
No significant differences in the heart rate and blood pressure were noted between groups (p > 0.05). There were no
complications related to the TAP block.
Conclusions: The TAP block is a safe and effective adjunctive method of pain relief after caesarean delivery.
Key words: TAP block, caesarean section, postoperative pain
Ginekologia Polska 2018; 89, 8: 420–423
Corresponding author:
Anna Kupiec
Chair and Clinic of Anaesthesiology and Intensive Care,
Jan Mikulicz-Radecki University Teaching Hospital in Wrocław, Borowska St. 213, 50–556 Wrocław, Poland
e-mail: annakupiec11@gmail.com
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Anna Kupiec et al., The analgesic efficiency of transversus abdominis plane (TAP) block after caesarean delivery
Table 2. Tramadol requirement, systolic blood pressure, diastolic blood pressure and heart rate in TAP block group and control group. Data are
presented as mean (SD)
Postoperative
TAP block group Control group p
time interval
Tramadol requirement [mg] 0–12 h 234.0 (135.9) 309.6 (90.1) 0.005
0h 118.9 (14.1) 116.3 (13.2) 0.37
3h 119.5 (11.2) 119.8 (14.6) 0.96
Systolic blood pressure [mm Hg]
6h 119.5 (13) 119.8 (14.3) 0.81
12 h 119 (12.9) 118.0 (10.6) 0.88
0h 72 (10.5) 65.4 (9.9) 0.002
3h 72.5 (7.2) 70.4 (12.2) 0.62
Diastolic blood pressure [mm Hg]
6h 73.3 (9.3) 73.2 (11.5) 0.93
12 h 74.3 (11) 72.3 (9.1) 0.33
0h 77.5 (12.0) 76.6 (11.7) 0.81
3h 76.8 (12.0) 73.1 (11.3) 0.15
Heart rate
6h 75.3 (11.5) 73.6 (12.0) 0.45
12 h 76.0 ( 9.7) 74.6 (11.2) 0.43
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