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TAP vs. ESP Blocks for Post-Cesarean Analgesia
Sponsor: Maternity Hospital - State Budgetary Institution of the Rostov Region, Taganrog
Summary
This study compares the effectiveness of two ultrasound-guided nerve blocks (TAP block and ESP block) versus standard pain management for relieving pain after a planned cesarean section. Cesarean delivery often causes moderate to severe pain, which can be divided into somatic pain (from the abdominal incision) and visceral pain (from uterine contractions and internal tissues). While transversus abdominis plane (TAP) blocks are commonly used, erector spinae plane (ESP) blocks are a newer technique that may provide better relief for visceral pain. In this randomized controlled trial, 162 women undergoing elective cesarean delivery under spinal anesthesia will be assigned to one of three groups: 1. Bilateral ESP block at the L1 level; 2. Bilateral TAP block; 3. Standard analgesia without nerve blocks. The primary goal is to determine which method provides better control of visceral pain in the first 16 hours after surgery. Secondary goals include assessing somatic pain, time to first mobilization, time to first skin-to-skin contact with the baby, and the need for additional rescue pain medication. The study aims to support early recovery and improve mother-infant bonding by optimizing postoperative pain control.
Official title: Comparative Efficacy of Transversus Abdominis Plane (TAP) and Erector Spinae Plane (ESP) Blocks for Postoperative Analgesia After Elective Cesarean Section: A Prospective, Single-Center, Randomized Controlled Trial
Key Details
Gender
FEMALE
Age Range
18 Years - 40 Years
Study Type
INTERVENTIONAL
Enrollment
162
Start Date
2026-10-15
Completion Date
2027-06-10
Last Updated
2026-10-06
Healthy Volunteers
No
Interventions
Ropivacaine
0.375% solution for ultrasound-guided nerve blocks.
Ultrasound-guided Nerve Block
Bilateral TAP or ESP block performed in the post-anesthesia care unit.
Ketoprofen and Paracetamol
Baseline multimodal analgesia administered to ALL groups: Ketoprofen 100 mg IM at 4 hours postoperatively, followed by oral paracetamol + ketoprofen at 12 hours.
Trimeperidine (Rescue)
Rescue analgesia (Trimeperidine 20 mg IM) administered ONLY in the Control Group if NRS pain score \> 4.
Ultrasound-guided ESP Block
Bilateral ESP block at L1 level with 20 mL of 0.375% ropivacaine per side.
Ultrasound-guided TAP Block
Bilateral TAP block with 20 mL of 0.375% ropivacaine per side.
Ropivacaine
0.375% solution for nerve blocks.
Locations (1)
Maternity Hospital - State Budgetary Institution of the Rostov Region, Taganrog
Taganrog, Rostov Oblast, Russia