Revolutionizing Postoperative Pain Relief: The Power of Transdermal Fentanyl Patch Combined with TAP Block in LSCS Under Spinal Anaesthesia – A Randomized Clinical Trial

Background: Postoperative pain relief is an essential aspect of all surgical procedures. The modalities available for postoperative pain management include oral tablets, intramuscular injection, intravenous injection, neuraxial nerve block with opioids, transdermal patches, and suppositories.
Objectives: Our study aims to assess the postoperative analgesic efficacy of a Fentanyl patch along with a Transversus Abdominis Plane (TAP) block in a caesarean section.
Methodology: A prospective, randomized research. One hundred patients of ASA I and II posted for elective LSCS were randomized into Group A and Group B to receive either a USG-guided TAP block (15ml of 0.25% bupivacaine) along with a fentanyl patch 3 mg (fentanyl patch delivered at 25 mcg/hr), or USG guided TAP block (15ml of 0.25% bupivacaine) with a placebo patch after the procedure respectively. Parameters like Visual Analog Scale (VAS), sedation score, and complications were noted. The Mann-Whitney U test was used for the VAS score and sedation score analysis. Complications were analysed using the Chi-square test.
Results: Postoperative analgesia was more effective in Group A (2829.6 ± 162.6 min) than in Group B patients (374.64 ± 23.4 min), significantly. The patients who required rescue analgesia were lower in Group A, 5 out of 50. There were no significant side effects.
Conclusion: Transdermal fentanyl patch (25 mcg/hr) along with USG-guided TAP block provided more effective analgesia than TAP block with a placebo patch without any significant complications in patients who underwent caesarean section in the postoperative period.