The exclusion criteria were as follows: local infection major hepatic, renal, or cardiovascular disease a bleeding disorder known anaphylaxis to any drug used in the trial and a contraindication to regional anesthesia. Sixty women aged 18–40 years with American Society of Anesthesiologists physical status ІІ who were scheduled for elective cesarean delivery via a Pfannenstiel incision under intrathecal anesthesia were included in the trial. The primary study outcome was the duration of analgesia provided by these two types of block.Ĭonsort flow diagram of the study population. The aim of this study was to compare the analgesic efficacy of bilateral ESP block with that of bilateral TAP block after elective cesarean delivery under spinal anesthesia. We hypothesized that bilateral ESP block would provide more effective and prolonged pain relief than TAP block after elective cesarean delivery and could be used as part of a multimodal opioid-sparing analgesia technique. Recent publications have demonstrated that the ESP block serves as a practical component of a multimodal regimen for pain relief after various types of operations, including cesarean delivery, by blocking both the dorsal and ventral branches of the thoracic and abdominal spinal nerves therefore, it provides both somatic and visceral analgesia.
TAP block has gained popularity as an effective analgesia technique in mothers undergoing cesarean delivery and works by blocking the anterior rami of the spinal nerves of the abdominal anterior wall after spreading of the local anaesthetic agent in the neurofascial plane between the internal oblique and transversus abdominis muscle, thereby relieving the pain of cesarean section. Various techniques are used for postoperative pain relief after cesarean delivery under spinal anesthesia, including intrathecal and/or systemic opioids, abdominal nerve blocks, and truncal blocks such as the transversus abdominis plane (TAP) block with parenteral analgesics and bilateral erector spinae plane (ESP) block. However, despite these benefits, spinal anesthesia does not provide adequate postoperative pain relief. Further advantages are that there is no risk of failed intubation or aspiration of gastric contents and no requirement for use of depressant drugs. 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. Postoperative pain relief after elective cesarean delivery is challenging because it needs to provide maternal satisfaction while having no adverse effects on the baby.