Abstract: Objective To compare the analgesic efficacy of anterior axillary line approach with subcostal approach in ultrasound-guided transversus abdominis plane block after cesarean delivery. Methods Singlebirth primigravida 144 cases undergone longitudinal incision cesarean section with single spinal anesthesia were randomly divided into group A (anterior axillary line approach group) and group B (subcostal approach group)(n= 72). All cases in the two groups were done via ultrasound guided transversus abdominis plane block after surgery; 30 mL of 0.25% ropivacaine were injected in each side after ultrasound to determine the transversus abdominis plane. Visual analogue pain (VAS) score in postoperative 6, 12, 24, 48 h time points, analgesic intensity peak time, postoperative ambulation time and patient satisfaction with postoperative analgesia in the two groups were observed. Results Visual analog pain (VAS) score in postoperative 6, 12, 24, 48 h time point between the two groups was not statistically significant difference (P> 0.05). Time of analgesic intensity peak time in group A was (2.9±1.8) h and group B (2.6±1.4) h with no significant difference (P> 0.05). The average time to get out of bed in the two groups showed no significant difference (P> 0.05). Patient satisfaction with postoperative analgesia in the two groups was no significant difference (P> 0.05).Conclusion Postoperative analgesia in cesarean section with longitudinal incision via either anterior axillary line approach or subcostal approach in ultrasound-guided transversus abdominis plane block is available within 24 hours, both approaches are without difference.

Key words: ultrasound-guided transversus abdominis plane block, different approach, cesarean section, analgesia