The effectiveness of transversus fascia plane block applied postoperatively in patients who had cesarean section under spinal anesthesia

The Transverse Fascia Plan block is used to provide postoperative analgesia in many lower abdominal procedures such as cesarean section. Although the choice of anesthesia in cesarean delivery depends on many factors, it is mostly performed under spinal anesthesia. In this study, we aimed to investigate the contribution of TFP block performed under USG guidance to postoperative analgesia in patients who underwent elective cesarean section under spinal anesthesia. After obtaining the approval of the ethics committee and the patient, a total of 60 patients between the ages of 18 and 45, with ASA class II-III, who were planned for elective cesarean section under spinal anesthesia, were included. Patients were randomly divided into two groups: those who did not receive a block (Group Control) and those who received a TFP block (Group TFPB). Group TFPB patients were placed in the supine position at the end of the surgery. Group TFPB patients were placed in the supine position at the end of the surgery. Bilateral TFP block was performed with 0.25% plain bupivacaine for 20 ml in-plane technique between the iliac crest and costal edge under aseptic conditions. As part of multimodal analgesia, both groups of patients received the first dose of paracetamol near the end of the surgery, and the second dose was administered in the ward 6 hours later. After the patients were transferred to the ward, Diclofenac Sodium was administered 75 mg I.M. During the 24-hour follow-up, Paracetamol was given as 4x1gr I.V, Diclofenac Sodium was given as 75 mg 2x1 I.M. Once the patients left the operating room and pain monitoring began, the time at which the NRS exceeded 3 was determined and IV Tramadol was administered at a dose of 1 mg/kg as a rescue opioid analgesic, and when a second dose was needed, the interval was at least 6 hours. All patients' resting and moving NRS scores were evaluated at 1,3,6,12,24 hours after leaving the operating room, and the time elapsed until the first need for opioid analgesics. In addition, the total opioid consumption of all patients during at rest and during movement at the 1st, 3rd, 6th, 12th, and 24th hours after the operating room, complications and side effects resulting from TFP block (nausea, vomiting, tinnitus, metallic taste in the mouth, etc.), and the patient's satisfaction level at the end of 24 hours were evaluated. The demographic characteristics of the patients were similar. Group TFPB had significantly lower NRS values and less opioid use than the control group. Although the time until the first need for opioid analgesia was longer in Group TFPB, it was not found to be statistically significant. There was no difference between the groups in terms of total opioid consumption in the 24 hours postoperatively, complications and side effects related to the TFP block. Patient satisfaction was found to be higher in Group TFPB. The Transverse Fascia Plan Block is effective as part of multimodal analgesic methods in the treatment of pain after cesarean section. According to this study, we think that the TFP block is superior to the control group in terms of pain score, need for opioid analgesics and patient satisfaction.