This prospective randomized double blind case control study was conducted to evaluate transversus abdominis plane block using either Bupivacaine or Ropivacaine or Placebo for pain relief after caesarean section in relation to:

•Analgesic requirement during 24hours by patient controlled analgesia, • Patient satisfaction regarding analgesia, and • Adverse effects if any.

With the approval of institutional ethical committee, the study was performed on 90 ASA grade I & II patients admitted to our institute in the Deptt. of Obstetrics & Gynaecology undergoing either routine or non-urgent caesarean section under single shot spinal anaesthesia. All patients received a standard spinal anaesthesia and at the end of surgery a bilateral TAP block was performed. The patients were randomized into three groups(n=30): • Group B: Patient received TAP block with 0.5% Bupivacaine 15ml each side, • Group R: Patient received TAP block with 0.5% Ropivacaine 15ml each side, • Group S: Patient received TAP block with normal saline 15ml each side.

In addition, standard analgesic comprising of 75 mg Diclofenac 8 hourly and IV PCA Tramadol. Each patient was assessed postoperatively at 1,2,4,8,12,24 and 48 hours for pain score at rest and movement, nausea and vomiting, and sedation along with patient's satisfaction. Statistical analyses were performed using a standard statistical program (version 2.0: Jandel Corporation San Rafael, CA, USA).

Result: Use of Tramadol was reduced in patients given TAP block by 50% during 48 hrs after surgery (p<0.001) in the study groups(B,R) when compared to placebo group(S). Pain scores were lower both on rest and activity at each time point for 24 hrs in study groups (p<0.001), time of first analgesia was significantly longer, satisfaction was higher and side effects were less in study groups compared to control group.