Sarcouncil Journal of Medicine and Surgery

Abstract: Background: Anesthesiologists widely acknowledge that pain plays a critical role in recovery, albeit with a complex relationship to consciousness. While inadequate pain management may accelerate the recovery of consciousness, it can also provoke agitation in patients with impaired consciousness. Effective pain relief, such as through regional anesthetic techniques, can potentially lower the level of consciousness, particularly when long-acting analgesic medications are already in use. Aim: To evaluate the effect of pain relief by TAP block after caesarean section on the duration and quality of recovery from general anesthesia. Patients and Methods: This single-blinded clinical trial involved 60 pregnant women undergoing elective cesarean sections at the Diwaniyah Teaching Center from April to December 2024. Participants were randomly assigned to either the TAP block group (n = 30) or the control group (n = 30). Demographic data, extubation times, pain scores (using the Visual Analog Scale), rescue analgesia requirements, and hemodynamic parameters were recorded. The TAP block was administered bilaterally using 10 mL of plain Marcaine with dexamethasone and saline under ultrasound guidance. Data were analyzed using t-tests and chi-squared tests, with a significance threshold of p < 0.05. Results: The TAP block group exhibited significantly shorter extubation times (4.5 ± 1.8 minutes vs. 6.9 ± 1.8 minutes, p < 0.001) and consistently lower pain scores at 10, 20, and 30 minutes post-extubation (p < 0.001 for all intervals). Rescue analgesia was needed in only 13.3% of TAP patients, compared to 60% in the control group (p < 0.001). Hemodynamic parameters, including systolic blood pressure and respiratory rate, were more stable in the TAP group during recovery. However, the total recovery time from the last muscle relaxant to extubation was comparable between groups (p = 0.4). Conclusion: The TAP block significantly reduces postoperative pain and analgesic requirements while enhancing hemodynamic stability and recovery after cesarean sections under general anesthesia. These findings support its routine integration into multimodal analgesia strategies to improve maternal outcomes. Further studies are warranted to standardize protocols and evaluate long-term benefits.