The Effect of TAP Block with 0.25% Levobupivacaine and 0.25% Bupivacaine for Postoperative Analgesia in Lower Segment Cessrean Section
BACKGROUND: Transversus abdominis plane (TAP) block in cesarean section is carried out by local anesthetics such as bupivacaine or ropivacaine with a limited duration of analgesia. This double-blind, randomized controlled trial aimed to compare bilateral ultrasound-guided TAP block with bupivacaine and levobupivacaine for analgesia after cesarean delivery performed under spinal anesthesia. Aims: The aim of this study was to compare the duration of postoperative analgesia between levobupivacaine (0.25%) versus bupivacaine (0.25%) alone in the bilateral TAP block after lower segment cesarean section (LSCS). Materials and methods: In this prospective randomized double-blind interventional study, 100 parturients undergoing elective LSCS were included in the study. Patients were randomly divided to receive either 20-ml levobupivacaine 0.25% (Group A; n = 50) or 20-mL bupivacaine (0.25%) bilaterally (Group B; n = 50) in TAP block in a double-blind fashion. The total duration of analgesia, patient satisfaction, total requirement of analgesics in the first 24 h, and the side effects sedation, hypotension, and bradycardia were observed. Statistical analysis: Statistical tests were conducted using SPSS. P < 0.05 was considered as statistically significant. Results: A total of 100 patients were analyzed. Duration of analgesia was significantly longer in Group B (10.94 ± 0.56 h) compared to Group A (6.16 ± 0.81 h) (P < 0.001). Mean consumption of tramadol was 134.77 ± 14.90 mg and 78.89 ± 28.77 mg in Groups A and B (P < 0.001), respectively. All patients in Group B were extremely satisfied while those in Group A were satisfied (P < 0.01). None of the patients experienced any side effect like hypotension or bradycardia. sedaion were comparable in both the groups. Conclusion: 0.25% bupivacaine in TAP block bilaterally for cesarean section significantly increases the duration of postoperative analgesia, decreases postoperative rescue analgesic requirement, and increases maternal comfort compared to 0.25% ml of levobupivacaine.