Fentanyl Transdermal Patches versus Transversus Abdominis Plane Block in Post Cesarean Section Pain control

Document Type : Original Article

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1 Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

2 Department of Anesthesiology and Intensive Care, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Abstract

Background: Perioperative pain management planning is necessary. The transversus abdominis plane (TAP) block was first employed to produce a field block utilizing the Petit triangle as a landmark-guided method. Transdermal administration has been utilized for the delivery of medications such nitroglycerin, clonidine, and scopolamine. 
The Aim of The work: An ultrasound-guided Transversus Abdominis Plane (TAP) block was compared to fentanyl patches for managing postpartum pain 24 hours after caesarean surgery.
Patients and Methods: A randomized controlled trial was conducted on 100 pregnant women who were scheduled for elective caesarean birth under spinal anesthesia. Following surgery, participants were randomly assigned to one of two equal groups. The first group got transdermal fentanyl patches at a rate of 50 μg/h (TFPs). Following surgery, the second group had a transversus abdominis plane (TAP) block with 20 mL of 0.25 percent bupivacaine.
Results: In terms of the modified Observer's Assessment of Alertness/Sedation (OAA/S) Scale, statistical analysis of the current data revealed no statistically significant variation between the examined groups (p=0.101). However, at 2, 4, 6, 12 and 24 hours, VAS score and pain threshold were significantly lower with TFPs than with TAP block (p=0.033, 0.024, 0.007, 0.002 and 0.002, respectively). Hypotension was significantly more frequent with TFPs compared with TAP block (16 vs. 2%) p= 0.031. 
Conclusion: Using transdermal fentanyl patches for postoperative analgesia after caesarean section was more effective than transversus abdominis plane block. 

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