Please select the eligibility criteria that correspond to the clinical trial below.
Title: Transversus Abdominis Plane (TAP) Block Versus Intrathecal Morphine for Caesarean Section - Randomised Controlled Trial
Brief Summary: Analgesia after cesarean section is still not satisfactory for many women. Even if pain reduction is sufficient with the technique of intrathecal morphine injection, side effects such as nausea and pruritus are common.

Since several years, an alternative technique has been studied, the "transversus abdominis plane (TAP)"-block. Here a local anesthetic is injected in the abdominal wall muscles, and this has been shown to give a similar analgesic effect compared to intrathecal morphine, with potentially less side effects.

With this study, we want to evaluate if the TAP-block yields indeed less side effects when compared with intrathecal morphine.

The study will be a prospective study with the patients randomized to either a group with intrathecal morphine or a group with TAP-block.


Options:
A: Inclusion Criteria:

Subjects must satisfy all of the following criteria to be enrolled into the study:

* American Society of Anesthesiology (ASA) physical status less than 3 Able to read and understand the information sheet and to sign and date the consent form
* Scheduled for elective C-section planned with spinal anaesthesia
* Age\>18

Exclusion Criteria:

Potential subjects who meet any of the following criteria will be excluded from participating in the study:

* Complicated pregnancy defined as having preeclampsia or placenta accreta, increta and percreta.
* Drug addiction.
* Contraindication to spinal anaesthesia (history of clotting disorders, septicemia, local infection at the injection site, spinal malformation, elevated intracranial pressure)
* Contraindication to TAP block (skin infection, abdominal wall muscle defect such as hernia and previous abdominal wall mesh).
* BMI\>40 kg/m2
* Weight less than 50 kg the day of the C-section.
* Height less than 150 cm or more than 175 cm.
* Allergy/contraindication to any medication used in the study.
* Previous median abdominal incision. Necessity to perform the C-section urgently before the scheduled date (with less than 24h preparation time).
B: Inclusion Criteria:

* English speaking ASA I-II non-laboring women with single gestations ≥36 weeks
* Scheduled or unscheduled cesarean delivery under spinal anesthesia
* Height: 5 feet-5 feet 11 in.

Exclusion Criteria:

* Laboring women needing an emergency cesarean delivery

  * Subjects less than 18 years of age
  * Receipt of a drug with antiemetic properties in the 24 hours prior to cesarean section
  * Allergy to ondansetron, or metoclopramide
  * Severe hypertensive disease of pregnancy defined as systolic blood pressure (SBP)\>160mmHg, diastolic blood pressure (DBP)\>110mmHg requiring antihypertensive treatment or associated with significant proteinuria.
  * Severe Cardiac disease in pregnancy with marked functional limitations
  * Diabetes type I
  * Patients on Monoamine Oxidase Inhibitors or Tricyclic Antidepressants
  * Morbid obesity (body mass index (BMI)\>45)
  * Inclusion in another anesthetic study involving drug administration
C: Inclusion Criteria:

* Healthy (i.e., ASA I, or II) patients presenting for planned c-section at New York Methodist Hospital
* Signed informed consent

Exclusion Criteria:

* They are unable or unwilling to take part in the study
* They have a history of an allergy to any medications used including ginger
* They have had any gastrointestinal surgery on the stomach, small intestine, or gall bladder.
* They have any history of bleeding disorder, (i.e., Hemophilia A/B, ITP, etc.)
* They have a contraindication to intrathecal or epidural anesthesia. ( i.e., Arnold- Chiari malformation, etc.)
* They are unable to understand instructions or questions related to study
* ASA III or IV patients
D: Inclusion Criteria:

* Women aged 18-46 presenting for scheduled primary or repeat cesarean sections and have consented to study

Exclusion Criteria:

* allergy to dexamethasone or morphine
* history of gastrointestinal disease
* history of severe nausea during pregnancy (hyperemesis gravidarum)
* use of anti-emetic in the past 24 hours
* history of gestational diabetes or diabetes mellitus
* history of hypertension prior to or during pregnancy
* presence of non-viable fetus

Answer: A