Ultrasound Guided Transversus Abdominis Nerve Block versus Bilateral Ultrasound Guided Ilioinguinal-Iliohhypogastric Nerve Block in Elective Cesarean Section in El-Demerdash Hospital. A Randomized Controlled Trial

Abstract

Abstract Background Pain after CS is a primary concern of women and the provision of effective analgesics is an essential duty for the obstetric anaesthetist. After the application of ultrasound in anesthetic practice, we can now choose between a landmark- or ultrasound-guided TAP block, Ilio- inguinal nerve block (alone or in combination with an Iliohypogastric nerve block) among others. Objective To compare the effect of bilateral ultrasound guided TAP block versus ultrasound guided Ilioinguinal and Iliohypogastric nerve block on post-operative analgesia in patients undergoing elective Cesarean section under spinal anesthesia. Patients and Methods The study was conducted on 64 random patients per each group who were scheduled to undergo elective cesarean section under spinal anesthesia, the two groups were as following; Results As for the comparison between effect of TAP block and ilioinguinal-iliohypogastric block as regard post-operative pain in elective cesarean section under spinal anesthesia, it showed that there is significance regarding the numeric version of the VAS score and its intensity. These findings the TAP block more effective than the ilioinguinal-iliohypogastric block. These findings with our primary and secondary outcomes showed that TAP block has more analgesic effect with respect to ilioinguinal-iliohypogastric block regarding pain assessment but with no significant difference regarding the time till first analgesia postoperative and total analgesics consumption over 24-hour period post-operative. Conclusion The comparison between effect of TAP block and ilioinguinal-iliohypogastric block as regard post-operative pain in elective cesarean section under spinal anesthesia showed significant difference regarding the numeric version of the visual analogue scale (VAS) that was used to assess postoperative pain and its intensity. These findings with our study primary and secondary outcomes showed that TAP block has more analgesic effect with respect to ilioinguinal-iliohypogastric block regarding pain assessment and the time till first analgesia postoperative and total analgesics consumption over 24-hour period post-operative.