The aim of this study is to compare Surgical Transversus abdominis plane block and Ultrasound guided transversus abdominis plane block (TAPB) as a postoperative analgesic regimen in female patients undergoing elective cesarean delivery.
Caesarean delivery rates have been increasing worldwide nowadays. At rate of \[52%\], Egypt stands out among countries with the world's highest cesarean delivery percentages . Within the Arab region, rate of cesarean section far higher in Egypt than other Arab countries. A much simpler and theoretically superior means of establishing a TAP block. When using a transcutaneous (conventional) approach there is always the risk of peritoneal puncture with its attendant complications. Moreover, there are technical difficulties, especially in obese women and the procedure requires specialist equipment, a skilled operator and training in ultrasonography. Our approach obviates these risks and difficulties because the procedure is carried out under direct vision, and it is much easier to perform by the surgeon during caesarean section.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
50
performed by 40 ml of 0.25% bupivacaine (10 ml 0.5% bupivacaine bilaterally diluted with 10cc normal saline and 100 μg of fentanyl), the total volume was divided equally and administered bilaterally by the surgeon.
performed by 40 ml of 0.25% bupivacaine (10 ml 0.5% bupivacaine bilaterally diluted with 10cc normal saline and 100 μg of fentanyl), the total volume was divided equally and administered bilaterally.
Kohaf
Cairo, Egypt
RECRUITINGTime to perform block.
The time taken to perform the block will be recorded by an independent observer.
Time frame: 1 hour postoperatively
Heart rate
Patients hemodynamics (heart rate will be recorded)
Time frame: 24 hours postoperatively
Mean arterial blood pressure
Patients hemodynamics (mean arterial blood pressure will be recorded)
Time frame: 24 hours postoperatively
Pain score
The Visual Analogue Scale (VAS) measures pain intensity. The VAS consists of a 10cm line, with two end points representing 0 ('no pain') and 10 ('pain as bad as it could possibly be').
Time frame: 24 hours postoperatively
Time to first analgesic request
The time to first analgesic request will be recorded
Time frame: 24 hours postoperatively
Amount of post operative analgesic consumption
The amount of post operative analgesic consumption will be recorded
Time frame: 24 hours postoperatively
Time spent in operating room
The time spent in operating room will be recorded
Time frame: 24 hours postoperatively
Incidence of Adverse reactions
Adverse events will be recorded such as nausea, vomiting, hypotension (Mean arterial blood pressure \< 20% of baseline readings and will be managed by ephedrine 5 mg IV and/or normal saline IV) and bradycardia (heart rate \< 60 beats/min and will be managed by atropine 0.6 mg IV).
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Time frame: 24 hours postoperatively