TAP vs. ESP Blocks for Post-Cesarean Analgesia

This study compares the effectiveness of two ultrasound-guided nerve blocks (TAP block and ESP block) versus standard pain management for relieving pain after a planned cesarean section. Cesarean delivery often causes moderate to severe pain, which can be divided into somatic pain (from the abdominal incision) and visceral pain (from uterine contractions and internal tissues). While transversus abdominis plane (TAP) blocks are commonly used, erector spinae plane (ESP) blocks are a newer technique that may provide better relief for visceral pain. In this randomized controlled trial, 162 women undergoing elective cesarean delivery under spinal anesthesia will be assigned to one of three groups: 1. Bilateral ESP block at the L1 level; 2. Bilateral TAP block; 3. Standard analgesia without nerve blocks. The primary goal is to determine which method provides better control of visceral pain in the first 16 hours after surgery. Secondary goals include assessing somatic pain, time to first mobilization, time to first skin-to-skin contact with the baby, and the need for additional rescue pain medication. The study aims to support early recovery and improve mother-infant bonding by optimizing postoperative pain control.