الفهرس 
Anatomy and PhysiologyOnly 14 pages are availabe for public view
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Abstract
Background: Cesarean delivery (CD) is one of the most commonly performed operations and is associated with significant postoperative pain, often requiring opioids in hospital and following discharge. Aim of the Work: to compare analgesic effectiveness of bilateral US guided Transversus Abdominis Plane block (TAP) versus single-shot local anesthetic Wound site Infiltration (WI) after cesarean delivery under general anesthesia.Patients and Methods: After ethical committee approval and informed consent from the patients, the present randomized controlled trial was conducted at Ain Shams University hospitals during the period from January to June 2021 on 195 cases with 3 groups 65 in each group TAP group, infiltration group and control group Results: The current study revealed that there was No significant statistical differences between the studied groups regarding demographic characteristics; maternal age,body mass indexand parityas well as gestational age and operation time in our study Postoperative patients’ pain perceptionathours 1, 2, 4, 6, 12 and 24was lowest in TAP group, followed by WI group and highest in control group, the differences were statistically significant between all the studied groups but at hours 1 and 2the differences were statistically significant between control and each of TAP and WI groups with no significant difference between TAP and WI groups. Consequently, patient Satisfaction was highest in TAP group, followed by LWI group and lowest in control group, the differences were statistically significant between all the studied groups (p value=0.001). our results revealed. Time to first rescue analgesia was longest in TAP group, followed by LW group and shortest in control group, the differences were statistically significant between all the studied groups.Consequently, Rate of first rescue analgesia was lowest in TAP group, followed by LW group and highest in control group, the differences were statistically significant between all the studied groups. Our results revealed Total NSAID dose was lowest in TAP group, followed by LWI group and highest in control group, the differences were statistically significant between the studied groupsOur results revealed Time to first opioid dose was least in TAP group, followed by WI group and highest in control group, the differences were statistically significant between all the studied groups Consequently Rate offirst opioid dose was lowest in TAP group, followed by LW group and highest in control group, the differences were statistically significant between all the studied groups. Consequently, the onset of mobilization was shortest in TAP group, followed by LWI group and longest in control group, the differences were statistically significant between the studied groups (p value<0.001).Our study revealedPostoperative nausea and vomiting were least frequent in TAP group, followed by WI group and most frequent in control group, the differences were statistically non-significant in nausea, while in vomiting the differences were statistically significant between control and each of TAP and WI groups with no significant difference between TAP and WI groups.Postoperative pruritis were not recorded in all of the studied groups. Conclusion TAP block appeared to be supe¬rior to local anesthetic wound infiltration with respect to postoperative analgesia in the set¬ting of a multimodal analgesic regimen.TAP block provided better pain relief, less analgesic requirement and early mobilization than local wound infiltration after Cesarean section under general anesthesia. Moreover, it is associated with minimal postoperative complications, so should be preferred over local anesthetic wound infiltration as postoperative analgesic regimen.