Comparative study to evaluate analgesic efficacy between USG -guided transverse fascia plane block and conventional ilioinguinal/ iliohypogastric nerve block for inguinal surgeries -Prospective randomized trial

Pain is perhaps the most petrified symptoms of surgery, especially in the  paediatric age groups which is being tried to alleviate and conquer since ages. Fear of needles and mask, emotional liability and a limited reserve of vital function are the confounding factor, contributing further to the difficulties in dealing with this vulnerable age group. The ability to express distress and discomfort is limited in young children due to difficulty in communication,thus pain is usually underestimated and treated, causing impairment in pulmonary, cardiovascular, gastrointestinal, Neuro-endocrine and metabolic function.

Inguinal surgeries are among the most common day care procedure in children.Various modalities have been used to cure postoperative pain.Peripheral nerve blocks with local anesthetics are commonly employed method in subumblical surgeries.Iliogastric and Ilioinguinal nerve blocks (IINB) are used,combined with general anaesthesia for intraoperative supplementation and also as a sole entity for postoperative pain.The IINB has been found to decrease the requirement of analgesics for up to 48hrs after inguinal surgeries.Nowadays USG guided peripheral block are commonly used for effective amelioration of the same and has been regarded as a gold standard for nerve localization in clinical anaesthesia. USG Transeverse fascia plane block (TFP) is the preferred method to reduce the use of opioids and systemic analgesics for postoperative pain management.TFP block provide anaesthesia and analgesia in the inguinal region by blocking the ilioinguinal and iliohypogastric nerves.The ilioinguinal/Iliohypogastric (II/IHB) is a widely used regional anaesthesia technique in inguinal hernia repair surgery.However,this block provides limited analgesia during and after surgery,and the patients feel pain when walking.The transverse fascia plane block is a recently developed technique and several case reports presented its efficacy for inguinal repair surgeries in adult patients.It may block not only ilioinguinal and iliohypogastric nerves but also splanchnic nerves,which is conveyed via thoracolumber fascia and  mayprovide better and prolong analgesia.