{
  "abstract": "Background and Aims Open fetal surgery for spina bifida offers significant fetal benefits but poses challenges in maternal postoperative pain management. Enhanced Recovery After Surgery (ERAS) principles emphasize effective, opioid-sparing analgesia to improve maternal recovery. While epidural and systemic opioids are commonly used, their application may be limited by side effects or technical difficulties. The transversus abdominis plane (TAP) block is widely used in obstetric surgery, yet its use in fetal interventions has not been clearly defined. This study aims to evaluate the efficacy of bilateral TAP block for postoperative analgesia following fetal spina bifida repair.Methods This case series included five pregnant women (aged 27–34) who underwent open fetal spina bifida repair at 26 weeks of gestation. Following induction of general anesthesia and prior to surgical incision, bilateral ultrasound-guided TAP block was performed using 20 mL of 0.25% bupivacaine per side. Postoperative pain was assessed using Visual Analogue Scale (VAS) scores at 2, 4, 8, 12, and 24 hours. Analgesic satisfaction and opioid requirement were also recorded.Results All five patients were extubated postoperatively without complications and transferred to intensive care. VAS scores remained consistently low across all time points, with minimal variation between patients, and no scores exceeding 3. No additional systemic opioids were required. All patients reported high analgesic satisfaction and were discharged from intensive care within 24 hours and from the hospital on postoperative day three. No adverse events related to the TAP block or pain management protocol were observed.Conclusions Bilateral TAP block appears to be a safe and effective option for postoperative analgesia in fetal spina bifida surgery. This opioid-free technique may contribute to improved maternal recovery, reduced opioid-related side effects, and aligns well with ERAS principles. Further studies are warranted to confirm these findings.",
  "authors": [
    {
      "affiliations": [
        "Anesthesiology and Reanimation, Hasekİ Training and Research Hospital, Istanbul, Turkey"
      ],
      "name": "İlke DolĞun"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Beykent University, Istanbul, Turkey"
      ],
      "name": "Ibrahim Alatas"
    },
    {
      "affiliations": [
        "Department of Pediatric Surgery, Florence Nightingale Hospital, Istanbul, Turkey"
      ],
      "name": "Kerem Ozel"
    },
    {
      "affiliations": [
        "Clinic of Obstetrics and Gynecology, Special Doctor, Istanbul, Turkey"
      ],
      "name": "Ali Ekiz"
    }
  ],
  "title": "EP057 Bilateral transversus abdominis plane block for opioid-free postoperative analgesia after open fetal spina bifida repair: a case series",
  "uid": "9dc7f5d6-562d-5fde-a26c-f97de52a9fb7"
}