Comparison of Postoperative Analgesic ID Efficacy of Different Methods After Cesarean-Section

Abstract

Objective: In this research study,we compared postoperative analgesic effects of general anesthesiafollowed with transversus abdominis plane block (TAPB), epidural or spinal anesthesia andwe 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 thestudy was obtained, the study population scheduled for elective cesarean operations was dividedin three subgroups as spinal, epidural and general anesthesia. Group T consisted of 30 cases thatunderwent general anesthesia and TAP; Group E consisted of 32 cases that underwent epiduralanesthesia; and Group S consisted of 30 cases that underwent spinal anesthesia. All casesreceived 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 andside 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 analgesianeed (Table II). The need for postoperative tramadol was minimum for patients in Group E andmaximum for patients in Group S (p<0.05). VAS scores at postoperative 0., 1. and 6. hours weresignificantly lower for patients in Group E (p<0,05). Regarding the groups T and S, VAS scores at6. 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 thebest method for decreasing postoperative consumption of tramadol. Epidural anesthesiaincreased the postoperative analgesic efficacy and decreased the tramadol consumption inpatients undergoing TAP block. In order to increase the comfort of the mother and newborn, TAPBmay be an option for patients who are not candidates for epidural anaesthesia.