Comparison of the Effectiveness of Ultrasound-guided Transversalis Fascia Plane Block (TFPB) and Transversus Abdominis Plane Block (TAPB) on Postoperative Pain in Caesarean Section: A Prospective Randomized Study

Objective:Postoperative peripheral trunk blocks are used for multimodal analgesia in caesarean sections. This trial was planned to compare the efficacy of transversalis fascia plane block (TFPB) and transversus abdominis plane block (TAPB) in postoperative analgesia in patients undergoing caesarean section under spinal anaesthesia.Method:In this prospective trial, ASA II-III risk group patients between the ages of 20-50 years who were scheduled for elective caesarean section under spinal anaesthesia were evaluated. Demographic data, duration of operation, presence of intraoperative and postoperative nausea & vomiting, pruritus, duration of first analgesia requirement, visual analogue scale (VAS) values for 24 hours postoperatively, paracetamol, diclofenac sodium, the total amount of non-steroidal anti-inflammatory drugs (NSAIDs) used were recorded.Results:Patients were randomized into two groups: TFPB (75, 50%) and TAPB (75, 50%) groups. There was no significant difference in demographic data, comorbidity, ASA classification and operation times between the two groups (p>0.05). When the duration of the first postoperative analgesia requirement was evaluated, it was higher in the TFPB group (p<0.05). The 24-hour pain scores (VAS 6th hour and VAS 12th hour) were lower in the TFPB group (p<0.05). The amounts of paracetamol, diclofenac and total NSAIDs were higher in the TAPB group (p<0.05).Conclusion:USG-guided bilateral TFPB is more effective than TABP for postoperative analgesia in caesarean sections

The effect of anesthetic agents used in oocyte collection on intracytoplasmic sperm injection results in patients treated for infertility due to male factor

Aim: Different anesthetic methods and agents are used for transvaginal oocyte retrieval procedures (TORP) in assisted reproductive techniques (ART). In our study, we evaluated prospectively the effect of propofol and thiopental sodium during TORP on intracytoplasmic sperm injection (ICSI) results in the spouses of patients with male factor indication.Material and Methods: The study was approved by the ethics committee with Protocol No. 2019-21-07 on dated October 28, 2019. Sixty female patients who underwent TORP for intracytoplasmic sperm injection were included in the study. Anesthesia was randomized into two groups according to propofol (GP) or thiopental sodium (GT) used for induction and maintenance anesthesia. Patients' demographic data, effects of the anesthetic drug used on hemodynamics and nausea and vomiting, laboratory parameters including fertilization rate, cleavage rate, optimal embryo rate and implantation rate, and pregnancy outcomes were recorded.Results: Sixty patients, including the propofol group (n:30) and the thiopental sodium group (n:30), were evaluated. Mean age, body mass index and motile sperm count were similar in both groups. Mean arterial pressures and nausea and vomiting rates were lower in GP (p<0.05). Although intracytoplasmic sperm injection, pronucleus, MII oocyte values were statistically significantly higher in GP, B-HCG and clinical pregnancy outcomes were similar in both groups.Discussion: Our findings revealed that propofol and thiopental sodium, the anesthetic agents used in transvaginal oocyte collection procedure before ICSI treatment, had similar effects on clinical pregnancy. The results of our study are similar to many studies in the literature