Transversus Abdominis Plane Block versus Epidural Anesthesia for Pain Management Post-Caesarean Delivery: A Pilot Study

Figures & data

Figure 1 The CONSORT flow chart of study population.

Table 1 The Patient’s Characteristics and Operative Data

	TAP Block (n=25)		Epidural (n=24)		p value
	n	%	n	%
Operation
Horizontal Pfannenstiel	22	88.0	22	91.7	0.083^b
Vertical	3	12.0	0	0.0
Horizontal Joel Cohen	0	0.0	2	8.3
Comorbidities
Yes	5	20.0	4	16.7	0.527^b
No	20	80.0	20	83.3
Cause of caesarean
Cephalopelvic disproportion	4	16.0	9	37.5	0.318^b
Non-reassuring fetal state	3	12.0	3	12.5
Iterative	3	12.0	1	4.2
Others	15	60.0	11	45.8
Motor block	0	0.0	3	100.0	0.110^b
	Mean	SD	Mean	SD	p value
Age (years)	24.6	4.8	25.2	5.7	0.779^c
Weight (kg)	69.5	13.4	73.5	14.4	0.362^c
Height (m)	1.6	0.1	1.6	0.1	0.062^c
BMI	27.9	4.4	28.3	4.6	0.960^c
Bleeding (mL)	449.6	150.2	385.8	111.1	0.132^c
Incision size (cm)	15.3	1.7	14.8	1.4	0.307^c
Hospital discharge (days)	2.0	0.0	2.0	0.2	0.340^c

Notes: Variables are reported as number and percent or mean ± standard deviation. ^bFisher test; ^cU de Mann Whitney test.

Abbreviations: TAP, transversus abdominis plane; BMI, body mass index; n, number; SD, Standard Deviation.

Table 2 VAS Scores Among Different Study Groups

	TAB Block (n=25)		Epidural (n=24)
Pain*	Mean (CI 95%)	Median (IR)	Mean (CI 95%)	Median (IR)	GLM** for Difference (95% CI)	p value
VAS 0h	0.04 (−0.04; 0.12)	0.0 (0.0)	0.5 (0.17; 0.83)	0.0 (1.0)	− 0.46 (−0.77; −0.14)	0.004
VAS 6h	1.16 (0.61; 1.71)	1.0 (2.0)	2.0 (1.69; 2.31)	2.0 (0.0)	− 0.84 (−1.45; −0.23)	0.007
VAS 12h	2.88 (2.38; 3.38)	2.0 (2.0)	2.42 (2.09; 2.74)	2.0 (1.0)	0.46 (−0.11; 1.03)	0.110
VAS 24h	3.40 (2.99–3.81)	4.0 (2.0)	3.17 (2.82; 3.51)	3.0 (2.0)	0.23 (−0.28; 0.75)	0.372

Notes: *Friedman test: 118.79 (p value <0.01; =0.77), **Generalized Linear Model. Estimated difference between TAP block versus Epidural.

Abbreviations: VAS, Visual Analog Scale; CI, Confidence Interval; IR, interquartile range; n, number; h, hours.

Figure 2 VAS scores among different study groups and estimation of marginal means.

Notes: (A) displays the mean difference in pain scores (VAS) between the epidural and TAP Block groups. The figure is accompanied by a measure of uncertainty, the 95% confidence interval. (B) shows the marginal averages of the pain scale (VAS) after estimating the changes for both techniques (Epidural vs TAP block) at 0h, 6h, 12h, and 24h, accompanied by the 95% confidence interval.

Table 3 Conover’s Post Hoc Comparisons - VAS

		T-Stat	df	p	pbonf	pholm
VAS 0h	VAS 6h	3.929	144	< 0.001	< 0.001	< 0.001
	VAS 12h	7.607	144	< 0.001	< 0.001	< 0.001
	VAS 24h	10.199	144	< 0.001	< 0.001	< 0.001
VAS 6h	VAS 12h	3.678	144	< 0.001	0.002	< 0.001
	VAS 24h	6.270	144	< 0.001	< 0.001	< 0.001
VAS 12h	VAS 24h	2.592	144	0.011	0.063	0.011

Abbreviations: VAS, Visual Analog Scale; h, hours; df, degrees of freedom; pbonf, p value of bonferroni test; pholm, p value of Holm test.