Background and Goal of Study:
Postoperative anesthesia in obstetrics has always been relevant. There is a central and peripheral neuraxial blockade, as well as multimodal analgesia in the arsenal of an anesthesiologist for confronting postoperative pain. Each method has its strengths and weaknesses. We have compared the effectiveness of analgesia and the degree of activity of women in labor after peripheral and central neuraxial blockades - the lateral TAP block verses prolonged epidural analgesia. Period of mobility activation within the ward as well as the intensity of pain on the Visual Analog Scale (VAS) were subject to assessment.
Materials and Methods:
The study included women at the age from 18 to 43 with full gestational term (38-42 weeks) without major somatic pathology, primiparous and multiparous for urgent or planned Cesarean section (CS). The method of anesthesia has been spinal anesthesia.
158 patients undergoing CS under spinal anesthesia were randomized to postoperatively receive prolonged epidural anesthesia (Group E, n=76) or ultrasound-guided transversus abdominis plane (TAP) block (Group T, n=82). The control group of patients under multimodal analgesia included 79 persons.
2.5 hours after admission to the ward in group T, the TAP block was carried out at a single dose bilaterally ultrasound-guided with a solution of Ropivacaine 0.375% 20 ml with Dexamethasone 4 mg. In group E, a solution of Ropivacaine 0.2% 10 ml bolus was injected into the epidural catheter and subsequently every 2 hours at the same dosages. In cases of insufficient level of anesthesia, both groups received Tramadol, as well as Paracetamol upon request.
The pain level  at rest and on coughing was assessed on VAS, the period of mobilization in the ward was also recorded.


06 / The effectiveness of analgesia and the activity of TAP-block patients in comparison with prolonged epidural analgesia: a randomized, prospective, controlled trial