RESUMO
BACKGROUND: Injection of local anesthetic into the transversus abdominis plane (TAP block) decreases systemic morphine requirements after abdominal surgery. We compared intraoperative surgeon-administered TAP block (surgical TAP) to anesthesiologist-administered transcutaneous ultrasound-guided TAP block (conventional TAP) for post-cesarean analgesia. We hypothesized that surgical TAP blocks would take less time to perform than conventional TAP blocks. METHODS: We performed a randomized trial, recruiting 41 women undergoing cesarean delivery under neuraxial anesthesia, assigning them to either surgical TAP block (n=20) or conventional TAP block (n=21). Time taken to perform the block was the primary outcome, while postoperative pain scores and 24-hour opioid requirements were secondary outcomes. Student's t-test was used to compare block time and Kruskal-Wallis test opioid consumption and pain-scores. RESULTS: Time taken to perform the block (2.4 vs 12.1â¯min, Pâ¯<0.001), and time spent in the operating room after delivery (55.3 vs 77.9â¯min, Pâ¯<0.001) were significantly less for surgical TAP. The 24â¯h morphine consumption (P=0.17) and postoperative pain scores at 4, 8, 24 and 48â¯h were not significantly different between the groups. CONCLUSION: Surgical TAP blocks are feasible and less time consuming than conventional TAP blocks, while providing comparable analgesia after cesarean delivery.
