الفهرس 
Aim of the studyOnly 14 pages are availabe for public view
 |  | from | 136 |  |  |
| | | from | 136 | | |
Abstract
Postoperative pain relief after elective cesarean delivery is challenging because it needs to provide maternal satisfaction while having no adverse effect on the baby. Caesarean delivery is the most common inpatient surgical procedure performed worldwide. Improving the peri-operative care of parturient has significant global implications. Acute postpartum pain is a leading anesthetic concern for women; is a key determinant of maternal satisfaction; may lead to persistent postoperative pain; is a predictor of postpartum depression; and can reduce early breastfeeding success. Effective postoperative analgesia should, therefore, be prioritized to improve outcomes following caesarean delivery. Spinal anesthesia is the most well-known technique used in cesarean delivery operations because it provides effective and rapid anesthesia and is technically easy to perform. Further advantages are that there is no risk of failed intubation or aspiration of gastric contents and no requirement for use of depressant drugs. However, despite these benefits, spinal anesthesia does not provide adequate postoperative pain relief. Various techniques are used for postoperative pain relief after cesarean delivery under spinal anesthesia, including intrathecal and/or systemic opioids, abdominal nerve blocks. The transversus abdominis plane (TAP) block is a regional anesthesia technique that provides analgesia to the parietal peritoneum as well as the skin and muscles of the anterior abdominal wall following abdominal surgery. It has become increasingly popular worldwide because of its relative simplicity and efficacy. The use of ultrasound improves the success rate and accuracy of nerve blocks and prevents potential complications.
So, the aim of the study was to evaluate the impact of the QLB and the TAP on acute pain occurrence in patients after elective cesarean delivery. To elucidate our aim, this study was clinical trial study on a 60 pregnant women’s was under taken in obstetrics and gynecology department in Al Mahmoudia general hospital at El Beheira governorate in period time from May 2021 to July 2022. The cases were sub divided into two groups included group A: included patients received (QLB), group B: included patients received (TAPB).
The results of this study could be summarized as follow: • There was no significantly difference between the two studied groups. regarding age, residence, occupation and BMI (p>0.05). • There was significantly increase among QLB (88.07±4.42) than TAPB (85.67±4.16) regarding Mean arterial blood pressure in operating room. While, there was significantly increase among TAPB (78.60±5.33) than QLB regarding Heart rate in operating room. while, there was no significantly difference between the two groups regarding Oxygen saturation in operating room (p >0.05). • First analgesic dose request was significantly increase among QLB than TAPB (P= 0.003). • Pain at rest, Pain at movement and Pain during cough were no significantly difference among two studied groups (p> 0.05). • There were significantly difference increase in TAPB than QLB regarding at 6 h, and 18 h as well as total amount of analgesia at 72 h. while, there were no significantly difference between TAPB and QLB regarding consumption at 4 h and at 12 h +(p> 0.05).
• There was no significantly deference between two studied groups regarding Postoperative nausea, Postoperative vomiting, Pruritus at 24 and Pruritus at 48 h (p>0.05). • VAS at 2h, 4h and 8h were significantly increase among TAPB (3.87 ±1.22, 3.43±0.94, 3.13±1.04) respectively than QLB (3.27±1.11, 3.00±0.95, 2.57±1.19) respectively. while, there were no significantly deference between two studied groups regarding VAS 12h and VAS 24 (p>0.05). • Patient satisfaction was high significantly deference between two studied groups (p=0.048). • Obstetric quality of recovery score was no significantly deference between two studied groups (p>0.27).