Original Research

Transversus abdominis plane block after Caesarean section in an area with limited resources

Desale Tewelde Kahsay, Waltraud Elsholz, Habteselassie Zerezghi Bahta
Southern African Journal of Anaesthesia and Analgesia | Vol 23, No 4 | a1073 | DOI: https://doi.org/10.1080/22201181.2017.1349361 | © 2017 Desale Tewelde Kahsay, Waltraud Elsholz, Habteselassie Zerezghi Bahta | This work is licensed under Other
Submitted: 17 November 2025 | Published: 30 August 2017

About the author(s)

Desale Tewelde Kahsay, Department of Anesthesia and Critical Care, Asmara College of Health Sciences, Asmara, Eritrea
Waltraud Elsholz, Department of Anesthesia and Critical Care, Asmara College of Health Sciences, Asmara, Eritrea
Habteselassie Zerezghi Bahta, Department of Obstetrics and Gynecology, Orotta School of Medicine, Asmara, Eritrea

Full Text:

PDF (150KB)

Abstract

Background: The primary objective of this study was to assess whether transversus abdominis plane (TAP) block is effective as part of multimodal pain management following Caesarean section in an area with limited resources. The study also looked at the advantage of this block in reducing the consumption of morphine and diclofenac postoperatively.
Methods: After approval by the institutional ethics committee and informed consent of participants, 108 ASA I and II patients for Caesarean section under spinal anaesthesia were randomly allocated to either the TAP block group or the control. The TAP block group received a landmark-orientated, bilateral TAP block in the triangle of Petit. Postoperative pain treatment followed the same protocol for both groups. Visual analogue scale (VAS) pain scores were measured at 2, 4, 6, 8, 12, 18 and 24 h postoperatively. At the same time, consumption of diclofenac and morphine was measured and compared.
Results: No adverse effects of the TAP block were detected. VAS pain scores were significantly lower in the TAP block group at rest, deep breathing, intentional coughing, and mobilisation in all cases (p < 0. 05). Morphine and diclofenac consumption was significantly higher in the control group (p < 0. 001).
Conclusion: TAP block reduced the VAS pain scores significantly both at rest and during stressors. As a result, morphine and diclofenac consumption was significantly reduced in the TAP block group. Therefore, it is feasible to implement TAP block as part of a multimodal analgesia regimen after Caesarean section in a tertiary health care centre in a developing nation.

Keywords

caesarean section; pain management; regional anaesthesia; transversus abdominis plane block; visual analogue scale

Metrics

Total abstract views: 151
Total article views: 59

 

Crossref Citations

1. Effectiveness of perineural and intravenous dexamethasone added to bupivacaine for transversus abdominis plane block in post-cesarean delivery pain control: A prospective cohort study
Abebayehu Zemedkun, Wosenyeleh Admasu, Bedru Jemal, Sileshi Abiy, Simeneh Mola, Hailemariam Mulugeta
International Journal of Surgery Open  vol: 24  first page: 143  year: 2020  
doi: 10.1016/j.ijso.2020.05.012

2. The Efficacy and Safety of Local Anesthetic Techniques for Postoperative Analgesia After Cesarean Section: A Bayesian Network Meta-Analysis of Randomized Controlled Trials
Jian Wang, Ge Zhao, Guang Song, Jing Liu
Journal of Pain Research  vol: Volume 14  first page: 1559  year: 2021  
doi: 10.2147/JPR.S313972

3. Comparing the analgesic efficacy of transversus abdominis plane block versus wound infiltration for post cesarean section pain management: A prospective cohort study
Wudie Mekonnen Alemu, Henos Enyew Ashagrie, Abatneh Feleke Agegnehu, Biruk Adie Admass
International Journal of Surgery Open  vol: 35  first page: 100377  year: 2021  
doi: 10.1016/j.ijso.2021.100377

4. Comparison of Spinal Morphine and Transversus Abdominis Plane Block on Opioid Requirements After Caesarean Section: An Observational Study
- Suwarman, Osmond Pison, Mohammad Maulana, Prapanca Nugraha
Local and Regional Anesthesia  vol: Volume 17  first page: 79  year: 2024  
doi: 10.2147/LRA.S459530

5. Transversus abdominis plane block compared with wound infiltration for postoperative analgesia following Cesarean delivery: a systematic review and network meta-analysis
Pervez Sultan, Selina D. Patel, Sandra Jadin, Brendan Carvalho, Stephen H. Halpern
Canadian Journal of Anesthesia/Journal canadien d'anesthésie  vol: 67  issue: 12  first page: 1710  year: 2020  
doi: 10.1007/s12630-020-01818-x

6. Comparison of analgesic modalities after cesarean section: a network meta-analysis and systematic review
Yimeng Jing, Shishun Zhao, Wenlai Guo, Lu Qin, Yaxin Li, Di You
International Journal of Surgery  vol: 111  issue: 5  first page: 3599  year: 2025  
doi: 10.1097/JS9.0000000000002352

7. Analgesic Effectiveness of Surgical Transversus Abdominis Plane Block after Cesarean Delivery
Hemapriya Lalchand, MR Anil Kumar, Hiteshi Venkatamurthy
Journal of South Asian Federation of Obstetrics and Gynaecology  vol: 16  issue: 2  first page: 83  year: 2024  
doi: 10.5005/jp-journals-10006-2379

8. Local anaesthetic techniques for post-caesarean delivery analgesia
S.D. Patel, N. Sharawi, P. Sultan
International Journal of Obstetric Anesthesia  vol: 40  first page: 62  year: 2019  
doi: 10.1016/j.ijoa.2019.06.002

9. Comparison of erector spinae plane and transversus abdominis plane block for postoperative analgesia after caesarean delivery under spinal anaesthesia: A randomised controlled trial
A. Eksteen, J. Wagner, T. Kleyenstuber, P. Kamerman
International Journal of Obstetric Anesthesia  vol: 60  first page: 104259  year: 2024  
doi: 10.1016/j.ijoa.2024.104259

10. Emergency nurses´ knowledge, attitude and perceived barriers regarding pain Management in Resource-Limited Settings: cross-sectional study
Desale Tewelde Kahsay, Marianne Pitkäjärvi
BMC Nursing  vol: 18  issue: 1  year: 2019  
doi: 10.1186/s12912-019-0380-9

11. Comparison of Ultrasound-Guided Transversus Abdominis Plane Block with Sub-Arachnoid Block for Open Inguinal Hernia Repair
Ashita Mowar, Vishwadeep Singh, Akhilesh Pahade, Geeta Karki
Anesthesia Essays & Researches  vol: 15  issue: 2  first page: 220  year: 2021  
doi: 10.4103/aer.aer_107_21

12. Efficacy of regional blocks or local anaesthetic infiltration for analgesia after caesarean delivery: a network meta‐analysis of randomised controlled trials
N. P. Singh, D. Monks, J. K. Makkar, A. Palanisamy, P. Sultan, P. M. Singh
Anaesthesia  vol: 77  issue: 4  first page: 463  year: 2022  
doi: 10.1111/anae.15645

13. The Efficacy and Safety of Transversus Abdominis Plane Blocks After Open Cholecystectomy in Low- and Middle-Income Countries
Amtul Mansoor, Stephen Ellwood, Gary Hoffman, Anthony Scholer, Amy Gore, Dennis Grech, Bradley Patrick, Ziad Sifri
Journal of Surgical Research  vol: 256  first page: 136  year: 2020  
doi: 10.1016/j.jss.2020.06.020

14. Efficacy of Surgical Transversus Abdominis Plane Block in Patients Undergoing Cesarean Delivery
Penumuchu Sravani, Sira P Rajanna, Rajiv K Saxena
Journal of South Asian Federation of Obstetrics and Gynaecology  vol: 12  issue: 5  first page: 302  year: 2021  
doi: 10.5005/jp-journals-10006-1828

15. A randomised comparative study of transversus abdominis plane block with or without intravenous diclofenac sodium as a component of multimodal regimen for post-operative analgesia following caesarean section
Bhati Kanta, Dhawan Sonali, Parveen Gazala, Khilji Yunus, Kuraning Kiran
Indian Journal of Anaesthesia  vol: 65  issue: 4  first page: 316  year: 2021  
doi: 10.4103/ija.IJA_761_20

16. Final-semester nursing studentś knowledge and attitude regarding pain management in resources limited setting
Tecleab Okubai, Selamawit Fessehaye, Andom Yohannes Gebray, Desale Tewelde Kahsay
International Journal of Africa Nursing Sciences  vol: 18  first page: 100542  year: 2023  
doi: 10.1016/j.ijans.2023.100542

17. Transverse abdominis plane block versus sodium diclofenac-acetaminophen combination for postoperative analgesia following cesarean section
Nived Mohanan, K Raghu
Bali Journal of Anesthesiology  vol: 4  issue: 2  first page: 39  year: 2020  
doi: 10.4103/BJOA.BJOA_4_20

18. Comparison of the effectiveness of transversus abdominis plane block with infiltration local anesthetic combination of intraoperative paracetamol as multimodal analgesia against pain intensity, first rescue opioid and interleukin-6 levels in postcesarean section patients with spinal anesthesia
Andi S. SARI, Andi M. TAKDIR MUSBA, Faisal MUCHTAR, Syafruddin GAUS, Ratnawati RATNAWATI, Ari S. PALINRUNGI
Gazzetta Medica Italiana Archivio per le Scienze Mediche  vol: 184  issue: 4  year: 2025  
doi: 10.23736/S0393-3660.24.05605-5

19. Transversus abdominis plane block versus wound site infiltration using 0.25% bupivacaine for post-operative analgesia after caesarean delivery performed under subarachnoid block
Deepak Kumar, Sonia Wadhawan, Amit Kohli, Poonam Bhadoria, Abhijit Kumar
Indian Journal of Clinical Anaesthesia  vol: 8  issue: 2  first page: 209  year: 2021  
doi: 10.18231/j.ijca.2021.042

20. Efficacy of ultrasound-guided TAP block for postoperative pain relief in abdominal surgeries: A prospective, randomized controlled trial
Heena Sanghavi, Vaishali Shelgaonkar
Indian Journal of Clinical Anaesthesia  vol: 10  issue: 3  first page: 223  year: 2023  
doi: 10.18231/j.ijca.2023.048