Abstract

Background: This study compared the analgesic efficacy of the bilateral erector spinae plane
(ESP) with that of the bilateral transversus abdominis (TAP) postoperative delivery with
selected surgery.
Methods: Sixty mothers scheduled for caesarean section under random surgery were
randomly assigned to receive an ESP block or a TAP block. The ESP group received USG
guided block with 20 mL 0.2% of ropivacaine at the T9 level corresponding to T10 transverse
process e at the end of surgery. The TAP group received an ultrasound-guided TAP block
containing 20 mL of 0.2% ropivacaine at the end of delivery. The main effect was the
duration of analgesia achieved by each block. Measures of the second outcome were
postoperative pain severity, complete diclofenac use, patient satisfaction.
Results: The median duration (interquartile) block was longer in the ESP group than in the
TAP group (12 hours [10-14] vs 8 hours [8-10], p <0.0001). In the first 24 hours, the median
rate of analog pain observed at rest was lower in the ESP group. Intermediate diclofenac use
in the first 24 hours was significantly higher in the TAP group than in the ESP group (125 mg
[100-150] vs 100 mg [75-100, p = 0.003]).
Conclusion: Compared with the TAP block, ESP block provides effective pain relief, has a
long lasting analgesic action, increases duration of first analgesic need, is associated with
minimal diclofenac use, and can be used in multimodal analgesia and opioid -sparing
medication after surgery.