Transversalis Fascia Plane Block Compared with Transversus Abdominis Plane Block for Postoperative Analgesia in Cesarean Section Under Spinal Anesthesia: A Retrospective Study

Objective: Transversalis fascia plane (TFP) and transversus abdominis plane (TAP) blocks are used for postoperative analgesia in many lower abdominal procedures such as cesarean section. This study aimed to retrospectively compare the postoperative effects of TFP and TAP blocks for postoperative multimodal analgesia in patients who underwent cesarean section under spinal anesthesia. Methods: We retrospectively searched electronic medical records to identify patients who underwent cesarean section under spinal anesthesia between November 2021 and June 2022. A total of 497 patients were identified, and 120 patients were included that meet our criteria in our analysis. The patients were divided into three groups: TFP, TAP, and control. Data were obtained from the files of the patients. Results: The block groups had significantly lower numeric rating scale (NRS) scores, less non-steroidal anti-inflammatory drug consumption, and lower complications than the control group. No opioid consumption was observed in the block groups. Although no non-steroidal anti-inflammatory drug consumption until the 4th hour and no opioid consumption until the 8th hour were observed in the control group, the need for additional analgesics increased as time passed. While the TFP group needed analgesics later than the TAP group, the NRS scores and total analgesic consumption were lower (p<0.001). Patient satisfaction was higher in the block groups than in the control group (p<0.001). Conclusion: Transversalis fascia plane and TAP blocks are effective as part of multimodal analgesia in cesarean section. The TFP block is superior to the TAP block in terms of pain scores, additional analgesic requirements, and patient satisfaction. Keywords: Cesarean section, postoperative pain, ultrasound-guided regional anesthesia, transversus abdominis plane block, transversalis fascia plane block