Comparison of transversalis fascia plane block versus ilioinguinal-iliohypogastric nerve block for postoperative analgesia in patients undergoing caesarean section

Caesarean section is associated with moderate-to-severe postoperative pain. Effective postoperative analgesia after LSCS is essential for early breast feeding and ambulation and has a role to play in decreasing postpartum depression. Transversalis fascia plane (TFP) block and ilioinguinal-iliohypogastric (ILIH) nerve block are regional anaesthesia techniques that have the potential to improve analgesia following caesarean section. This study will help us to determine which block has superior pain management properties.

A prospective, randomized, interventional study will be conducted in 80 American Society of Anaesthesiologists grade II parturients scheduled for elective caesarean section with Pfannenstiel incision under SAB, divided into two groups of 40 each. In group T, TFP block and in group I, ILIH block will be administered using 40 ml of 0.2% ropivacaine with 4mg dexamethasone (20 ml on each side) after completion of caesarean. The surgical site wound infiltration will be done with 10 ml of 0.2 % ropivacaine in both the groups. Postoperatively, monitoring of vitals and assessment of pain will be conducted using Numerical Rating Scale (NRS). Any patient complaining of NRS ≥ 4 will be administered rescue analgesic (Injection tramadol 50mg intravenously). The patient satisfaction score for pain management will be determined by five-point Likert scale. The total rescue analgesic consumption in 24 hours will be compared as a primary outcome and NRS scores, time to first rescue analgesic and patient satisfaction score will be compared for secondary outcomes.