• Ahmet Pinarbaşi, Başak Altiparmak, Melike Korkmaz Toker, Fatih Pirinççi, and Bakiye Uğur.
• From the Department of Anaesthesiology and Reanimation, Muğla Sitki Koçman University Faculty of Medicine (AP, BA, MKT, BU) and Department of Gynaecology and Obstetrics, Muğla Sitki Koçman University Faculty of Medicine, Muğla, Türkiye (FP).
• Eur J Anaesthesiol. 2024 Oct 1; 41 (10): 769778769-778.

BackgroundCaesarean section is a widely performed surgical procedure that often results in moderate-to-severe postoperative pain. If left untreated, this pain can lead to short-term and long-term consequences. Transversalis fascia plane (TFP) block and transversus abdominis plane (TAP) block are among the regional anaesthesia techniques employed for managing pain after a caesarean section.ObjectiveWe aimed to compare the impact of these two blocks on the quality of recovery in patients undergoing elective caesarean section under spinal anaesthesia.DesignA single-centre, double-blind, randomised trial.SettingsOperating room, postanaesthesia recovery unit, and ward in a tertiary hospital.ParticipantsNinety-three patients (ASA 2 to 3) were recruited. After exclusion, 79 patients were included in the final analysis: 40 in the TFP block group and 39 in the TAP block group.InterventionsAfter surgery, participants received either TFP block (20 ml 0.25% bupivacaine for each side) or TAP block (20 ml 0.25% bupivacaine for each side).Main Outcome MeasuresThe primary outcome was the difference in obstetric quality of recovery 11-Turkish (ObsQoR-11T) scores between groups. Secondary outcomes included pain scores, opioid consumption and incidence of opioid-related complications.ResultsThe mean ObsQoR-11T score was higher in the TFP block group compared with the TAP block group (97.13 ± 6.67 points vs. 87.10 ± 9.84 points, respectively; P  < 0.001). The pain scores in the TFP block group were slightly lower between postoperative 4 and 24 h. The mean total morphine consumption was 15.08 ± 2.21 mg in the TFP block group and 22.21 ± 3.04 mg in the TAP block group ( P  < 0.001). More patients required rescue analgesia between 4 and 8 h in the TAP block group [2.00 (5.00%) vs. 9.00 (23.08%), P  = 0.02]. No significant differences were observed between groups in terms of opioid-related side effects.ConclusionTFP block used for analgesic purposes yielded a better quality recovery period than TAP block and also reduced opioid consumption.Trial RegistrationClinicaltrials.gov (NCT05999981).Visual Abstracthttp://links.lww.com/EJA/B6 .Copyright © 2024 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.

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