Comparative Effectiveness of Ultrasound-Guided TAP Block and Surgical Site Infiltration on Post-Cesarean Pain Control and Early Breastfeeding | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 99, Volume 98, Issue 1, January 2025, Page 686-691 PDF (381.49 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2025.410536 | ||||
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| Abstract | ||||
| Background: Post-Cesarean pain management remains challenging, potentially affecting maternal recovery, infant care, and breastfeeding success. While both transversus abdominis plane (TAP) block and surgical site infiltration are established analgesic techniques, their comparative impact on early postoperative outcomes and breastfeeding initiation remains incompletely understood. Objective: This study aimed to compare the efficacy of TAP block versus wound infiltration for post-Cesarean analgesia. Patients and methods: A prospective, randomized study was conducted involving 194 women undergoing Cesarean delivery with spinal anesthesia at a single academic center. Participants were randomized to receive either an ultrasound-guided bilateral TAP block with 20 mL of 0.25% bupivacaine per side (n=97) or surgical site infiltration with 30 mL of 0.25% bupivacaine (n=97). Pain intensity, supplemental analgesic consumption, adverse effects, and breastfeeding initiation times were assessed over 24 hours postoperatively. Results: Median pain scores remained consistently low in the TAP block group (range: 1.61-1.73) compared to progressively increasing scores in the infiltration group, reaching 7.06 at 24 hours (p < 0.001). Notably, 82.5% of TAP block recipients required no supplemental analgesics, contrasting with universal analgesic requirements in the infiltration group. Hematoma formation was significantly less frequent with TAP block (4.1% versus 23.7%, p < 0.001). Early breastfeeding initiation (within 6 hours) was achieved by 55.7% of TAP block recipients compared to 8.2% in the infiltration group (p < 0.001). Neither group required opioid rescue analgesia. Conclusion: Ultrasound-guided TAP block provides superior postoperative pain control compared to surgical site infiltration following Cesarean delivery, characterized by sustained analgesic efficacy, minimal supplemental analgesic requirements, and reduced complications. The technique's association with earlier breastfeeding initiation suggests benefits extending beyond pain control, supporting its integration into enhanced recovery protocols for Cesarean delivery. | ||||
| Keywords | ||||
| Post-Cesarean analgesia; Ultrasound-guided TAP block; Surgical site infiltration; Postoperative recovery; Early breastfeeding | ||||
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