Effects of transversus abdominis and erector spinae plane blocks on postoperative pain control and postpartum depression after cesarean section: a randomized prospective study

TL;DR

This study compares two pain management techniques after cesarean section and finds no major difference in pain control or postpartum depression rates.

Contribution

The study provides a direct comparison of ESP and TAP blocks for postoperative pain and their impact on postpartum depression.

Findings

ESP block reduced the need for rescue analgesics compared to TAP block.

No significant difference in analgesic duration or postpartum depression rates between the two groups.

Lower pain scores at one hour post-surgery in the ESP group.

Abstract

Effective postoperative pain management after cesarean section is essential for maternal recovery. Poor pain control can lead to complications, including postpartum depression. This study aimed to compare the postoperative analgesic efficacy of erector spinae plane (ESP) and transversus abdominis plane (TAP) blocks following cesarean section, with a particular focus on their potential impact on postpartum depression.

Sixty patients were randomly assigned to receive either an ESP block (Group E, n = 30) or a TAP block (Group T, n = 30) after cesarean section. Pain severity was assessed using a visual analog scale (VAS), and the need for rescue analgesics and patient satisfaction were recorded. Postpartum depression was evaluated using the Edinburgh Postpartum Depression Scale (EPDS) at 4–6 weeks postpartum.

There was no significant difference between the groups in analgesic duration (Group E: 15 h, Group T: 14 h, p = 0.314). Group E showed a significantly lower need for rescue analgesics (0 vs. 1, p = 0.049). The VAS score at the first hour was lower in Group E (2 vs. 3, p = 0.032), but no differences were observed at subsequent time points. Postpartum depression rates were not statistically significant.

With the ESP block, no significant difference was observed compared to the TAP block in terms of total analgesic duration, opioid consumption, postpartum depression, or patient satisfaction, except for the postoperative 1-h VAS pain score. This suggests that the ESP block does not provide clear superiority over the TAP block.

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