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Dr. Muhammad Baqir MR Fakhrildin
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*Dr. Bahaulddin Zuhair Karieem and Dr. Hussein Munaf Ismail


Background: The transversus abdomenis plane (TAP) block is an effective method of providing postoperative analgesia in patients undergoing midline abdominal wall incisions. We evaluated its analgesic efficacy over the first (10) postoperative hours after cesarean delivery performed through a Pfannensteil incision, in a randomized controlled, double- blinded, clinical trial. Aim of study: This study is conducted to compare the effectiveness of TAP block versus traditional parenteral pain killer in reliefing pain after caesarian section. Patients and Methods: A randomized double blinded placebo controlled clinical trial conducted in the department of obstetrics & gynecology at Baghdad teaching hospital during the period between 1st march to 1st june 2012. Fifty female patients were selected to be enrolled in this study who were scheduled for C.S. via pfannenstiel incision, all patients were of ASA I-II physical status & randomlyselected. Twenty five of them were given TAP block with (lidocaine 1%) & placebo i.m saline (0.9%), the other twenty five were given i.m morphine & i.m diclofinac sodium & placebo TAP block with normal saline 0.9%. Numerical rating scale and graphic scale were used to follow up the patients after (2,6,8,10) hours during which intramuscular pethidine was given incrementally when the score was equal or more than five. Results: By comparing the means of numerical rating scale score over the time there was no significant difference in mean score over the time in both 2hr, 6hr post operatively where TAP block was better on the rest of time with a highly significant difference in P.value < 0.05 in all comparisons. Conclusions: TAP block is not effective as sole analgesic, but is effective in reducing the frequency of doses of incremental analgesia. TAP block is more effective than traditional analgesia in reducing the mean of pain score. The traditional parentral analgesia require more frequent dosing.

Keywords: TAP/parentral analgesia, cesarean section.

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