Ultrasound-guided Transversus Abdominis Plane Block and Ultrasound-guided Erector Spinae Plane Block for Postoperative Analgesia in Caesarean Section: A Randomised Clinical Study

Introduction: Pain is the most unpleasant subjective feeling comprising of innumerable emotional and psychological components that require medical advice for relief, regardless of the cause. Transversus Abdominis Plane (TAP) block and Erector Spinae Plane (ESP) block are effectively studied blocks that provide adequate pain control.<br /> Aim: To compare postoperative analgesic efficacy in pregnant women undergoing caesarean section under spinal anaesthesia with Ultrasound (USG)-guided TAP block and USG-guided ESP block.<br /> Materials and Methods: In this institution-based interventional randomised clinical study, two categories comprising 30 subjects in group I with USG-guided bilateral TAP block and group II with USG-guided bilateral ESP block using Ropivacaine were involved. Visual Analogue Scale (VAS) was used to compare analgesic efficacy. Other parameters for analysis included time of first rescue analgesia, total number of administrations of rescue analgesia within 24 hours, together with Adverse Drug Reactions (ADRs). Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 21.0. Student's t-test and Chi-square test were used for data analysis.<br /> Results: Subjects in group I had a mean age of 24.9 +/- 4.66 years while those in group II were 25.5 +/- 3.99 years. The VAS score at 24 hours in group I was 7.22 +/- 0.89 and in group II was 6.8 +/- 0.83, which was statistically significant with a p-value of 0.0241. USG-guided ESP block was superior to USG-guided TAP block, providing analgesia for 24 hours. Following the first dose, there was a significant delay in rescue analgesia and a reduction in the total administration of rescue analgesia within 24 hours. The first rescue analgesia in group I was at 10.66 +/- 2.32 hours and in group II was at 16.66 +/- 2.53 hours, with a p-value of 0.0001 indicating a statistically significant difference. No ADRs were reported in either group of participants.<br /> Conclusion: ESP block provided a prolonged duration of analgesia, as shown by a decrease in the total VAS score. There was also a significant reduction in the total number of administrations of rescue analgesia within 24 hours when compared to TAP block, suggesting that ESP block provides superior analgesia. Hence, for pain relief in postcaesarean section individuals, ESP block can be regarded as a novel potent option.