Ultrasound Guided Transversus Abdominis Plane Block versus Intrathecal Nalbuphine Injection for Postoperative Analgesia in Preeclamptic Patients Undergoing Cesarean Section

Introduction: Post-cesarean section effective analgesia is important, effective pain release helps in early mobilization and declines threat of thromboembolic diseases. The transversus abdominis plane (TAP) block is a regional analgesic procedure with a growing character in postoperative analgesia for lower abdominal surgeries. Nalbuphine, Intrathecal opioids has synergistic effect with local anesthetics and thereby exaggerate the sensory block without aggregate the sympathetic block. Patient and methods: 90 patients allocated as 30 patients in each group, all groups received intrathecal bupivacaine and TAP injection, group S had TAP injection with saline, Group B had TAP injection with bupivacaine, and group N had intrathecal nulbuphine and TAP injection with saline. Preoperative, at induction, intra and postoperative follow up of heart rate, systolic and diastolic blood pressure, total analgesic requirement (nalbuphine) in 24 hours, total I.V glyceraltrinitrate consumption in 24h, motor recovery, analgesic duration, Visual Analog Score (VAS) and effective analgesia time.Results: as regards analgesic duration and effective analgesia time, a significant increase in group N in comparison with group S and group B, also in group B compared with group S, while a significant decline in total analgesic dose in group N compared with other groups and by comparing group B with group S.Conclusion: Intrathecal nulbuphine and TAP block produce a significant prolongation in postoperative analgesic time and decrease postoperative analgesic consumption. However intrathecal nulbuphine showed significant advantages over TAP block.