Comparison Between Ultrasound Guided Transversalis Fascia Plane and Transversus Abdominis Plane Block on Postoperative Pain in Patients Undergoing Elective Cesarean Section: A Randomized Clinical Trial

Background: Postoperative pain is a common complication after Cesarean Section (CS) and its management is essential to prevent adverse effects of pain. Various methods are used to control pain after CS. Regional anesthesia using Transversalis Fascia Plane (TFP) and Transversus Abdominis Plane (TAP) block is shown to reduce pain after abdominal surgery. Objectives: This study aimed at evaluating the efficacy of these two methods in controlling pain after CS. Methods: In this randomized clinical trial, 56 patients undergoing elective CS under spinal anesthesia were randomly allocated to receive TFP or TAP block after surgery with ultrasound guidance. The pain severity using Visual Analogue Scale (VAS) at rest and during coughing at 0, 2, 4, 6, 12, 24, and 36 hours after surgery, time to first analgesic request, and dosage of analgesic use and complications were compared between groups. Results: There were no significant differences between groups in pain severity at rest or coughing at0, 2, 4, 6, 12, 24 and 36 hours, postoperatively. There was no considerable nausea and vomiting between groups (14.3% vs. 10.7%, P = 0.68), and time to the first analgesia (100.00 +/- 69.28 versus 123.12 +/- 50.19 minutes, P = 0.47) and total analgesic use (33.33 +/- 14.43 vs. 25.00 +/- 15.81 mg, P = 0.57) were comparable between groups. There were no complications in any of the groups. Patients in both groups were mostly satisfied for pain control after surgery (good to perfect, 89.3% versus 82.1%, P = 0.7). Conclusions: Ultrasound-guided TFP provided pain control the same as TAP block after CS with a comparable decreased need of analgesics.