Bilevel Erector Spinae Plane Block Versus Transversus Abdominis Plane Block for Analgesia After Cesarean Delivery.

Summary

Optimizing analgesia after cesarian delivery is an essential element of enhancing maternal recovery.A multimodal analgesic approach incorporating truncal blocks can provide effective pain relief with minimal side effects for both mother and infant.The posterior TAP block may provide enhanced effect due to possible retrograde spread to the paravertebral space.The ESP block has emerged as a valuable component of multimodal pain management, providing effective postoperative analgesia for various surgeries, including cesarean delivery. We hypothesized that the bilevel ESP block will offer superior analgesic efficacy compared to the TAP block and may be a valuable addition to multimodal analgesic regimens targeting opioid use reduction.

Timeline

Start

2025-10-01

Primary completion

2025-12-30

Completion

2026-01-15

Publications

• Results Kamel AAF, Amin OAI, Ibrahem MAM. Bilateral Ultrasound-Guided Erector Spinae Plane Block Versus Transversus Abdominis Plane Block on Postoperative Analgesia after Total Abdominal Hysterectomy. Pain Physician. 2020 Jul;23(4):375-382.
• Results Eksteen A, Wagner J, Kleyenstuber T, Kamerman P. Comparison of erector spinae plane and transversus abdominis plane block for postoperative analgesia after caesarean delivery under spinal anaesthesia: A randomised controlled trial. Int J Obstet Anesth. 2024 Nov;60:104259. doi: 10.1016/j.ijoa.2024.104259. Epub 2024 Aug 30.
• Results Chin KJ, El-Boghdadly K. Mechanisms of action of the erector spinae plane (ESP) block: a narrative review. Can J Anaesth. 2021 Mar;68(3):387-408. doi: 10.1007/s12630-020-01875-2. Epub 2021 Jan 6.
• Results Canakci E, Gultekin A, Cebeci Z, Hanedan B, Kilinc A. The Analgesic Efficacy of Transverse Abdominis Plane Block versus Epidural Block after Caesarean Delivery: Which One Is Effective? TAP Block? Epidural Block? Pain Res Manag. 2018 Oct 17;2018:3562701. doi: 10.1155/2018/3562701. eCollection 2018.
• Results Silverman M, Zwolinski N, Wang E, Lockwood N, Ancuta M, Jin E, Li J. Regional Analgesia for Cesarean Delivery: A Narrative Review Toward Enhancing Outcomes in Parturients. J Pain Res. 2023 Nov 10;16:3807-3835. doi: 10.2147/JPR.S428332. eCollection 2023.
• Results Hussain N, Brull R, Thaete L, Fuller S, D'Souza RS, Mankinen-Abdallah Y, Essandoh MK, Weaver TE, Abdallah FW. The analgesic effects of novel fascial plane blocks compared with intrathecal morphine after Caesarean delivery: a systematic review and meta-analysis. Br J Anaesth. 2025 May;134(5):1415-1431. doi: 10.1016/j.bja.2025.01.032. Epub 2025 Mar 11.
• Results Chou R, Gordon DB, de Leon-Casasola OA, Rosenberg JM, Bickler S, Brennan T, Carter T, Cassidy CL, Chittenden EH, Degenhardt E, Griffith S, Manworren R, McCarberg B, Montgomery R, Murphy J, Perkal MF, Suresh S, Sluka K, Strassels S, Thirlby R, Viscusi E, Walco GA, Warner L, Weisman SJ, Wu CL. Management of Postoperative Pain: A Clinical Practice Guideline From the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain. 2016 Feb;17(2):131-57. doi: 10.1016/j.jpain.2015.12.008.
• Results Mitchell KD, Smith CT, Mechling C, Wessel CB, Orebaugh S, Lim G. A review of peripheral nerve blocks for cesarean delivery analgesia. Reg Anesth Pain Med. 2019 Oct 25:rapm-2019-100752. doi: 10.1136/rapm-2019-100752. Online ahead of print.
• Results Sangkum L, Tangjitbampenbun A, Chalacheewa T, Brennan K, Liu H. Peripheral Nerve Blocks for Cesarean Delivery Analgesia: A Narrative Review. Medicina (Kaunas). 2023 Nov 4;59(11):1951. doi: 10.3390/medicina59111951.

Drugs

Indications

No indication recorded.