Randomized comparison between transversus abdominis and erector spinae blocks in cesarean section

Nimmala Vinod Kumar Reddy, Manjunath Prabhu, Sushma Thimmaiah Kanakalakshmi, Shiyad Muhamed

Research output: Contribution to journalArticlepeer-review


Introduction: Transversus abdominis plane (TAP) block provides somatic analgesia postoperatively in cesarean sections, however erector spinae plane (ESP) block has shown to provide both somatic and visceral analgesia. Objective: To compare the efficacy of TAP and ESP blocks for pain control after cesarean section under spinal anesthesia. Methods: In a double-blind superiority trial, pregnant patients undergoing cesarean section were randomized into either bilateral TAP or ESP block groups. Primary outcome was total consumption of patient-controlled analgesia (PCA) tramadol in the first 24 hours. Secondary outcomes included time required for first rescue analgesia, post-surgery visual analog score (VAS) for pain, patient satisfaction, and adverse effects. Results: 50 pregnant patients were randomized into TAP and ESP blocks. There was no difference in the amount of PCA tramadol within the first 24 hours between both groups [100mg (63-125) in TAP group vs 75mg (38-100) ESP group]. Pain score at rest and on movement and patient satisfaction were comparable in both groups, with no difference in adverse effects. There was a slight difference in the median time for first rescue analgesia [210min (135-315) in TAP group and 270min (225-405) ESP group] (p=0.03). Conclusions: TAP and ESP blocks provide similar analgesia with comparable consumption of tramadol in the first 24 hours post-cesarean section and no difference in pain scores at rest/on movement.

Original languageEnglish
Article numbere1072
JournalColombian Journal of Anesthesiology
Issue number3
Publication statusPublished - 2023

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine
  • Anesthesiology and Pain Medicine


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