Patient - Controlled Analgesia, Transversus Abdominis Plane Block and Non Steroidal Anti Inflammatory Drugs in Pain Control after Cesarean Section

Background: Cesarean section is frequently followed by moderate to severe pain that can impair early mobilization, breastfeeding, and maternal infant bonding. This research aimed to compare the effectiveness, safety, and patient satisfaction of ultrasound-guided transversus abdominis plane (TAP) block, intravenous patient-controlled analgesia (PCA), as well as non-steroidal anti-inflammatory drugs (NSAIDs) for postoperative pain control after cesarean section.Methods: This randomized controlled research included 48 term women undergoing repeat cesarean section who were categorized randomly into3 equal groups (n = 16): Group A received intramuscular diclofenac 75 mg every 8 h; Group B received bilateral ultrasound-guided TAP block with bupivacaine, magnesium sulfate, and dexamethasone; Group C received intravenous PCA. Pain was evaluated using a 10-cm VAS at multiple intervals during the first 12 h. Results: Significant differences in VAS scores were observed at 2 h (p = 0.011), 4 h (p = 0.0001), 6 h (p = 0.0001), and 8 h (p = 0.001), with TAP block showing lower scores than NSAIDs and PCA (pairwise p < 0.01). Time to first rescue analgesia was longest with TAP block (14.5 h) compared with PCA (9 h) and NSAIDs (5 h) (p = 0.0001). TAP block also enabled earlier ambulation than NSAIDs (p < 0.05). Nausea as well as vomiting were less significantly frequent in the TAP group (p = 0.002).Conclusion: Ultrasound-guided TAP block provided superior early postoperative analgesia, a longer pain-free interval, earlier mobilization, and fewer gastrointestinal side effects compared with PCA and NSAID-based regimens after cesarean section.