European Journal of Molecular & Clinical Medicine

Background: The aim of the study was to compare multi-modal approach with Tramadol suppository
and Ultrasound guided Transversus Abdominis Plane (TAP) Block with Bupivacaine versus Tramadol
suppository alone in providing adequate post-operative analgesia after Caesarean section.
Method: 158 patients, aged between 18 to 40 years with ASA physical status I-II scheduled for elective
caesarean surgery, were enrolled in this prospective randomized comparative study. 79 patients (of Group
A) were given Ultrasound guided Transversus Abdominis Plane Block with Bupivacaine and Tramadol
suppository as post-operative analgesia. The remaining patients were given only tramadol suppository as
post-operative analgesic (Group B). They were observed for 12 hours or till the patient requested for
rescue analgesic. Pain (VAS score), satisfaction (Likert scale), sedation (Four-point sedation scale),
nausea & vomiting (PONV Impact scale) and adverse effects at 3hours, 6hours, 9hours and 12hours postoperatively
were observed and compared in both the study groups.
Results: Both groups were comparable in demographic data. There was a statistically significant
difference between the VAS scores and satisfaction scores with a p < 0.001 between the two groups. No
statistically significant differences in the sedation, PONV or adverse effects were found between the two
groups. In our study, Group A patients who received ultrasound guided TAP block remained painless for
longer period (23hours) than Group B (6.5hours).
Conclusion: In conclusion, our study suggests that Ultrasound guided TAP block significantly improved
postoperative analgesia in women undergoing Caesarean delivery patients.