Analgesic Efficacy of Ultrasound-Guided Erector Spinae Plane Block versus Transversus Abdominis Plane Block for Post-cesarean Delivery Pain under Spinal Anesthesia

Balata, Ahmed Abdelhakim Abdelaziz; El-Dorgham, Lobna Taha; Ismai, Hossam Abdelbaqy Mahmoud; El-Dorgham, Lobna Taha

doi:10.21608/ejhm.2023.296200

Analgesic Efficacy of Ultrasound-Guided Erector Spinae Plane Block versus Transversus Abdominis Plane Block for Post-cesarean Delivery Pain under Spinal Anesthesia

Document Type : Original Article

Authors

10.21608/ejhm.2023.296200

Abstract

Background: Post cesarean delivery pain is a great problem that need approaches to enhance early recovery, activity, and encourages breastfeeding without any side effects. The perfect method for minimizing post-operative pain following cesarean delivery while under spinal anesthesia remains unknown. Although spinal or systemic opioids have been used to achieve effective painkillers, they are often accompanied by numerous adverse effects. The plane of the transversus abdominis (TAP) block's post-operative analgesic impact has already been applied to caesarean delivery women as a part of a multimodal analgesic strategy.
Objective: The aim of the current study was to minimize post cesarean delivery pain using either erector spinae plane (ESP) or TAP blocks after spinal anesthesia.
Patients and methods: A randomized controlled clinical trial was conducted in the Departments for Anesthesia, Intensive Care, and Pain Treatment at Zagazig University Hospitals, from September 2022 to March, 2023. The study was conducted on 36 women scheduled for category IV cesarean delivery and they were divided into 3 groups: Control group [group C]: n=12 patients underwent spinal anesthesia with (12.5mg hyperbaric bupivacaine) before cesarean delivery, ESP blocks group [group E]: n=12 patients were put under spinal anesthesia using (12.5mg hyperbaric bupivacaine) then they received an ultrasound-guided bilateral ESP block using (15 ml bupivacaine 0.25%) after finishing and dressing the cesarean delivery incision on each side, and TAP blocks group [group T]: n =12 patients underwent spinal anesthesia with (12.5mg hyperbaric bupivacaine) then they received an ultrasound-guided bilateral TAP blocks using (15 ml bupivacaine 0.25%) after completing and dressing the cesarean delivery wound on both sides.
Result: There were noticeable variations across the studied groups in terms of VAS on rest and movement in different follow-up periods, time to 1st analgesic request, total amount of pethidine iv and complications, with better outcomes in ESP blocks group. Conclusion: ESP block provided extended analgesia with appreciably lower analgesic requirements compared to TAP block and also associated with lower complications and higher patient satisfaction.

Keywords