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Abstract Cesarean delivery is a major surgical procedure, after which a woman can experience substantial postoperative discomfort or pain. Inadequate postoperative analgesia is one of the most common reasons for poor patient satisfaction following cesarean delivery. The provision of effective postoperative analgesia is key to facilitate early ambulation, infant care, and prevention of postoperative morbidity. The optimum form of postoperative analgesia is unknown, but many procedures are carried out under spinal anesthesia and patients typically receive spinal, systemic, or both opioids as a component of multimodal analgesia during the postoperative period. However, opioids, whether given via the spinal or systemic route, are frequently associated with adverse effects 11 such as nausea, vomiting, sedation and itching, and risk of delayed maternal respiratory depression, all of which reduce overall patient satisfaction. Knowledge about alternative (non-opioid) analgesia can help to replace or reduce opioid use and decrease opioid-related side effects. The transversus abdominis plane (TAP) block is a regional anesthetic technique that blocks T6-L1 nerve roots and can provide analgesia for lower abdominal procedures. Previous meta-analyses and recently published clinical trials have demonstrated promising results with this technique as part of multimodal postoperative pain treatment. The study was aimed to compare TAP block provided by the anesthesiologist using ultrasound or provided by the surgeon through caesarean incision regarding; Primary outcome: Duration of postoperative analgesia, Secondary outcome: Intensity of analgesia, Timing of mobilization, Easiness of the procedure. The study sample (90 pregnant females) was divided into two groups; the first group (45) received spinal anesthesia and postoperative ultrasound guided TAP block and second group (45) received spinal anesthesia plus TAP block done through cesarean incision. The main results of the study revealed that: • The mean age of parturients in US and intraoperative groups was 29.53±4.761 and 30.56±5.930 years respectively with no significant differences between the two groups P=0.370. • The mean gravidity of parturients in US and intraoperative groups was 1.93±1.074 and 2.24±1.095 respectively with no significant differences between the two groups P=0.095. • The mean parity of parturients in US and intraoperative groups was 0.80±1.036 and 1.09±0.900 respectively with no significant differences between the two groups P=0.055. |