Comparison of Postoperative Analgesic Efficacy of Different Methods after Cesarean-Section [Sezaryen Sonrası Farklı Yöntemlerin Arasında Postoperatif Analjezik Etkinliğin Karşılaştırılması]

Abstract

Objective: In this research study,we compared postoperative analgesic effects of general anesthesia followed with transversus abdominis plane block (TAPB), epidural or spinal anesthesia and we aimed to figure out the efficacy of TAPB for the postoperative pain. Method: After approval of the ethics committee (date: 03.25.2015; decision no: 142) for the study was obtained, the study population scheduled for elective cesarean operations was divided in three subgroups as spinal, epidural and general anesthesia. Group T consisted of 30 cases that underwent general anesthesia and TAP; Group E consisted of 32 cases that underwent epidural anesthesia; and Group S consisted of 30 cases that underwent spinal anesthesia. All cases received 75 mg IM diclophenac sodium after the operation. Data about the postoperative pain (the onset time of the pain, and the severity of the pain evaluated with VAS (Visual Analog Scale) and the need for adjuvant analgesics) were recorded. In addition, heart rate, blood pressure, peripheric oxygen saturation, respiration rates at postoperative 0., 1., 4., 6. and 12. hours and side effects seen were recorded. If the patient needed any additional postoperative analgesics, 50 mg tramadol was injected intravenously. Results: There was no significant difference between the groups regarding postoperative analgesia need (Table II). The need for postoperative tramadol was minimum for patients in Group E and maximum for patients in Group S (p<0.05). VAS scores at postoperative 0., 1. and 6. hours were significantly lower for patients in Group E (p<0,05). Regarding the groups T and S, VAS scores at 6. hours were significantly lower in Group T when compared with Group S (p<0.05). Conclusion: We found that the efficacy of the epidural anesthesia was more prominent and the best method for decreasing postoperative consumption of tramadol. Epidural anesthesia increased the postoperative analgesic efficacy and decreased the tramadol consumption in patients undergoing TAP block. In order to increase the comfort of the mother and newborn, TAPB may be an option for patients who are not candidates for epidural anaesthesia. © Copyright Anesthesiology and Reanimation Specialists’ Society.