Effects of transversus abdominis and erector spinae plane blocks on postoperative pain control and postpartum depression after cesarean section: a randomized prospective study.

Background/aim: Effective postoperative pain management after cesarean section is essential for maternal recovery. Poor pain control can lead to complications, including postpartum depression. This study aimed to compare the postoperative analgesic efficacy of erector spinae plane (ESP) and transversus abdominis plane (TAP) blocks following cesarean section, with a particular focus on their potential impact on postpartum depression. Materials and methods: Sixty patients were randomly assigned to receive either an ESP block (Group E, n = 30) or a TAP block (Group T, n = 30) after cesarean section. Pain severity was assessed using a visual analog scale (VAS), and the need for rescue analgesics and patient satisfaction were recorded. Postpartum depression was evaluated using the Edinburgh Postpartum Depression Scale (EPDS) at 4-6 weeks postpartum. Results: There was no significant difference between the groups in analgesic duration (Group E: 15 h, Group T: 14 h, p = 0.314). Group E showed a significantly lower need for rescue analgesics (0 vs. 1, p = 0.049). The VAS score at the first hour was lower in Group E (2 vs. 3, p = 0.032), but no differences were observed at subsequent time points. Postpartum depression rates were not statistically significant. Conclusion: With the ESP block, no significant difference was observed compared to the TAP block in terms of total analgesic duration, opioid consumption, postpartum depression, or patient satisfaction, except for the postoperative 1-h VAS pain score. This suggests that the ESP block does not provide clear superiority over the TAP block.