Efficacy of the Transversus Abdominus Plane (TAP) Block for Post-Cesarean Delivery Analgesia

A cesarean section is a surgical procedure and, like all surgeries, there is pain after the operation. The purpose of this study is to find out if patients have less pain after a cesarean delivery when they receive an injection of local anesthetic on either side of their abdomen, into the plane of the transversus abdominis muscle. We are also interested in whether or not this injection decreases the need for other pain-killing medication during this time.

Patients will randomly be assigned to receive either local anesthetic or a placebo. In addition, all patients will receive the usual standard of care and medication for pain. At 6, 12, 24 and 48 hours after the operation, patients will be asked about their pain and satisfaction with pain management. The risk of side effects is very low, as the block is done in an area with low blood supply. We propose that the addition of the TAP block to the current multi-modal regimen of post-cesarean pain management will reduce pain scores and requests for additional analgesia post-operatively, as well as increase patient satisfaction with their pain control.

Inclusion criteria

• Women undergoing elective cesarean delivery

Exclusion criteria

• Patients unable to communicate in English
• Patients with an American Society of Anesthesiologists (ASA) classification of 3 or higher
• Patients with contraindications to spinal anesthesia
• Patients with an allergy to ropivacaine, morphine, ketorolac or acetaminophen
• Patients who have taken any pain medication in the past 24 hours
• Patients with a BMI > 40