Abstract
BACKGROUND: Post-cesarean section (CS) pain satisfaction remains an issue. The purpose of this research was to evaluate the effectiveness of the transversus abdominis plane (TAP) block in comparison to intravenous analgesia controlled by patients for managing pain after CS in Iraq. OBJECTIVES: The study aimed to evaluate pain intensity as the primary outcome, alongside secondary outcomes including vital signs, nausea, vomiting, medication use, and inflammatory markers. METHODS: A quasi-experimental study was conducted at Wasit Investment Hospital in Kut, Iraq, involving 78 pregnant women undergoing elective CS. Sampling was conducted among eligible women who signed an informed consent form. Participants were classified into two groups based on the type of analgesia received after CS. The first group included women who received a TAP block using bupivacaine (n = 39). The second group consisted of those who used a patient-controlled analgesia (PCA) pump containing nalbuphine (n = 39). Pain intensity was measured using the Short Form McGill Pain Questionnaire (SF-MPQ; Arabic version) at 2, 4, 6, 12, and 24 hours following the CS. Laboratory tests, including a complete blood cell count (CBC) and high-sensitivity C-reactive protein (hs-CRP), were performed 24 hours after surgery. RESULTS: There were no notable differences in the demographic, clinical, or laboratory characteristics between groups (P > 0.05). Pain levels assessed using the SF-MPQ at 2, 4, and 6 hours post-surgery were notably lower in the TAP block group than in the PCA group (P = 0.009, P = 0.005, and P = 0.001, respectively). A positive and significant relationship between hs-CRP levels and pain intensity was identified across all measurement times in the TAP block group. CONCLUSIONS: The findings of this study showed that the use of a TAP block technique provided more effective pain relief than PCA during the first 6 hours after a CS.