Efficacy of Trans-Abdominis Plane Block for Post Cesarean Delivery Analgesia in Low-Income Countries: A Phase Three Feasibility Study

Author(s): Evans A Sanga, Ansbert Sweetbert Ndebea, Shuweikha Salim, Mwemezi Kaino, Bernard Njau, Rogers Temu

Background: Optimal pain control in a parturient woman undergoing caesarean section is essential for preventing complications and improving maternal satisfaction, early functional recovery, mother-baby bond and breastfeeding. Intentional pain assessment and adequate management to acceptable pain severity using multimodal methods can be achieved in low-middle income countries (LMICs).

Aim: Is to assess the efficacy of transversus abdominis plane (TAP) block and satisfaction post cesarean delivery analgesia at Kilimanjaro Christian Medical Centre in Low-Income countries.

Methods: The study of 72 participants for elective and emergency caesarean section. Blindly assigned into two groups 41 (interventional group) and 31 (Control). Interventional received 30ml 0.25% bupivacaine in each side for postoperative analgesia and Control, which was treated by the hospital pain management approach. Patients randomization and demographic were recorded before surgery, then were assessed for numeric pain score at rest and, on physical activities also patients, satisfaction at 0hrs, 6hrs, 12hrs and 24hrs.

Results: Total of 72 patients were analyzed with pain score at 0hr, 6hr and 12hr. It was significantly low by about 50% with p-value (2 tail) of < 0.001 however at 24 hrs. was 0.272. And also had improved movement 0hr, 6hrs and 12hrs with p-value <0.001 as compare to control which was limited though was not significant in coughing. Satisfaction with pain management was 95.1% with no reported adverse event.

Conclusions: Trans Abdominis Plane block when used as part of multimodal is an effective in managing postoperative pain with less physical limitation and high patients’ satisfaction in post caesarean section.