Comparison of post-operative analgesic efficacy between transversus abdominis plane block and local wound infiltration in caesarean section using bupivacaine and clonidine

Abstract

Background and Aims: Pain is the commonest complaint in post-operative period. Multimodal methods are employed to alleviate pain which helps in early ambulation and recovery. Here two regional anaesthesia techniques, Transversus Abdominis Plane (TAP) block and local infiltration anaesthesia are compared for post-operative analgesic efficacy. Methods: One hundred and ten patients undergoing Lower Segment Caesarean Section (LSCS) under Spinal Anaesthesia (SA) were randomly allocated into two groups of fifty five each, to receive either TAP block at the end of the procedure by nerve stimulator technique (Group T) or to receive Local Infiltration Anaesthesia [LIA] (Group L). Inj Bupivacaine 0.25% 40 ml with inj. Clonidine 1 µg/kg was used in both technique. Visual Analogue Scale (VAS) score was assessed at regular intervals. Duration of analgesia and requirements of tramadol in 24 hours was recorded and compared. Results: The duration of rescue analgesia for group T was 307.17±76.39 mins and for group L it was 147±53.88 mins. (P) value was found to be 0.0001, indicating it to be significant. Total requirement of Tramadol in 24 hours in group T was 96.67±31.98 mg whereas, group L had 235±43.85 mg with significant P value of 0.0001. Conclusion: TAP block with bupivacaine and clonidine was found to have significantly longer duration of analgesic effect with decreased requirement of tramadol in 24 hours when compared to local infiltration anaesthesia along with better patient satisfaction.