Abstract :
Cesarean section (CS) is now the most frequently performed surgery. Adequate postoperative pain control is essential to prevent complications. Regional block techniques are effective post-cesarean multimodal analgesia. The study compared the analgesic efficacy of bilateral erector spinae plane block (ESPB) with morphine-based PCA after elective CS under spinal anesthesia. The study included 40 females subjected to elective lower segment cesarean section (LSCS). They were randomly allocated to receive bilateral ESPB (ESPB Group, n=20) or morphine-based PCA (PCA Group, n=20) during the 24 postoperative hours. Paracetamol 1 gm IV infusion was given to all patients regularly every 6 hours. ESPB was performed at T9 level with the out-of-plane technique was done under sterile conditions. No complications were encountered during the performance of the blocks. Three hours after the end of surgery, patients were able to move their feet and legs freely. Sensory blockage showed the diffusion of local anesthetic from T6 level up to L1 level. The patients were monitored for pain intensity, total morphine consumption, and patient satisfaction. Starting from 2 to 6 hours and 24 hours after surgery, pain intensity was significantly lower in the ESPB group. Total morphine consumption was significantly lower in the ESPB group (p< 0.001). The degree of patients’ satisfaction with postoperative analgesia was significantly higher in the ESPB group (p< 0.001). ESPB is a safe and well-tolerated procedure for postoperative pain management after cesarean delivery.
