Postoperative analgesia after caesarean section with transversus ă abdominis plane block or continuous infiltration wound catheter: A ă randomized clinical trial. TAP vs. infiltration after caesarean section

Objective: Single shot transversus abdominis plane (TAP) block and ă continuous local anesthetic infiltration wound catheter (CLAIWC) ă decreased the morphine consumption after caesarean section. The aim of ă this study was to compare the analgesic efficacy of CLAIWC and ă ultrasound-guided TAP block. ă Method: Sixty patients undergoing caesarean section were prospectively ă randomized. After the caesarean section, the postoperative analgesia was ă randomized to either a CLAIWC localized below the fascia with an ă elastomeric pump for 48 hours or a bilateral ultrasound-guided TAP block ă with injection of ropivacaine. Every patient had a morphine pump ă patient-controlled analgesia. The primary outcome was the morphine ă consumption during the first 48 hours. Secondary outcomes were pain ă score levels, adverse effects of opioids, and patient satisfaction. ă Variables were collected during 48 hours after the caesarean section. ă Results: Median cumulative 48-hour morphine consumption was 17 [8-51] ă mg in the TAP group versus 21 [7-34] mg in the CLAIWC group (P = 0.3). ă We did not find a difference between the groups regarding pain, side ă effects and satisfaction scores. ă Conclusion: As part of a multimodal analgesic regimen, there is no ă significant difference between the TAP block and CLAIWC for ă postoperative analgesia after a caesarean section. (C) 2016 Societe ă francaise d'anesthesie et de reanimation (Sfar). Published by Elsevier ă Masson SAS. All rights reserved.