Ultrasound-Guided TAP Block and Spinal Morphine for Pain Relief After Caesarean Section

Study Overview
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Brief Summary
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This interventional double-blind randomized controlled study was carried out on 60 cases underwent elective caesarean section delivery, they were divided into 2 groups; patients were randomly allocated into two equal groups; Group M: received intrathecal 150 microgram morphine in a 0.5 ml volume, mixed with 10 mg of hyperbaric bupivacaine 0.5 % in a 2 ml volume (total volume 2.5 ml). Group B: received intrathecal 10 mg hyperbaric bupivacaine 0.5% 2ml volume + 0.5 saline (Total volume 3ml) and at the end of surgery patient received bilateral TAP block with 20 ml volume of 0.25% bupivacaine on each side.

Official Title
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Comparative Study Between Ultrasound-Guided Transversus Abdominis Plane Block and Spinal Morphine for Pain Relief After Elective Caesarean Section

Conditions
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Post Operative Pain

Intervention / Treatment
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* Procedure: Ultrasound-Guided Transversus Abdominis Plane Block
* Drug: Morphine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: pregnant females scheduled for elective cesarean section Exclusion Criteria: Patient refusal Patients with known allergies or with past history of allergy to local anesthesia Patients having an infection at the site of injection either in the back or in the abdominal region, Patients with coagulopathy or on systemic anticoagulation, Chronic opioid abuse, significant neurological, psychiatric or neuromuscular disease, Drug abuse and alcoholism, Obesity (BMI 30 and higher), Cardiovascular disease and Endocrine disorders.

Ages Eligible for Study
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Minimum Age: 20 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: transversus abdominis plain block group<br>post-cesarean section tap block will be given by ultrasound guidance using 20 ml bupivacaine local anesthetic 0.25% concentration for each side as an adjuvant to spinal anesthesia | Procedure: Ultrasound-Guided Transversus Abdominis Plane Block<br>* patient in the supine position, ultrasound will be used to identify the plane between the internal oblique and transversus abdominis muscle to inject 20 ml of local anesthetic for each side<br>|
| Experimental: intrathecal morphia group<br>intrathecal 150 microgram morphine in a 0.5 ml volume as an adjuvant to spinal anesthesia | Drug: Morphine<br>* intrathecal 150 microgram morphine in a 0.5 ml volume will be added to bupivacaine as an adjuvant to spinal anesthesia<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| prevention of post-operative pain | reduction of visual analogue scale post-operative | 72 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Ultrasound-Guided Transversus Abdominis Plane Block, Morphine, Caesarean section