الفهرس 
ANATOMY OF ABDOMINAL WALLOnly 14 pages are availabe for public view
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Abstract
Background: Caesarean section (CS) commonly induces moderate to severe pain for about 48 hours. It requires optimal perioperative pain management; which not only allows the mother to ambulate early but also plays a key role in the postoperative rehabilitation after CS.
Objective: To compare the first 24-hour postoperative analgesic efficiency of ultrasound (US)-assisted transversus abdominis Plane (TAP) block to IV morphine patient-controlled analgesia (PCA) in patients undergoing lower segment CS.
Patients and Methods: Forty-four pregnant female patients scheduled for elective cesarean section, under spinal anesthesia were included in this study. The patients’ age was ranged from 17 to 43 years and with the American Society of Anesthesiologists (ASA) Class-I and II.
Results: Our research study revealed that there was no significant differences between the studied groups regarding demographic characteristics; maternal age, BMI and parity as well as neonatal getational age and operation duration. Our research study revealed that postoperative pain perception at hours 2, 4, 6, 12 and 24 was non-significantly lower in TAP group than IV-PCA group. Our research study revealed that time to first rescue analgesia was non-significant differences in both groups. Our research study revealed that NSAIDS consumption was non-significantly less frequent in TAP group than IV-PCA group. Our research study revealed that the onset of mobilization was non-significantly shorter in TAP group than IV-PCA group. Our research study revealed that postoperative nausea and vomiting were significantly less frequent in TAP group than IV-PCA group. Postoperative allergy, and local complications not recorded in the studied groups.
Conclusion: The present study demonstrated that transversus abdominis plane block is effective as IVPCA in pain control after cesarean section in the first 24hr postoperative. It may be more effective than IV-PCA, as the analgesic effect starts earlier and decreases the systemic effect of the opioids used in PCA, however PCA is less invasive technique and easier to be used while TAP require hand skills.