COMPARISON OF EFFICACY OF ULTRASOUND GUIDED TRANSVERSE ABDOMINIS PLANE BLOCK VERSUS QUADRATUS LUMBORUM BLOCK ON POSTOPERATIVE PAIN IN PATIENTS UNDERGOING LSCS:A RANDOMISED CONTROL STUDY.

Cesarean section is the most common surgical procedure done in  obstetrics. Effective postoperative analgesia help parturient with early recovery, breastfeeding, and ambulation. Opioids are mainly used for postoperative pain management, but the limitation of opioids includes respiratory depression causing discomfort to the parturient, other insignificant side effects include itching, urinary retention, pruritis, and GI upset. The transverse abdominis plane block has a multimodal approach in post-operative pain management. In the transverse abdominis plane block, the local anesthetic solution is injected between the internal oblique and transverse abdominis muscle. Thoracolumbar nerves arise from T6- L1 spine roots and pass-through this plane and supply sensory nerves to the anterolateral abdominal wall. Quadratus lumborum is a posterior abdominal wall block that allows the spread of local anesthetic solution behind quadratus lumborum muscle and extends beyond the thoracolumbar fascia middle layer into a triangular space called the interfascial triangle. This space is near sympathetic fibers which extend to the thoracic paravertebral space. Ultrasound imaging has renewed interest in peripheral nerve blocks reducing the risk of needle contact with critical structures. In USG guided imaging, we can directly visualize the layers of muscles, the advancing needle and the injected fluid. The advantages are technical simplicity, high analgesic effectiveness, opioid sparing, long duration and minimal side effects. Ultrasound guided Transverse abdominis plane block and Ultrasound guided quadratus lumborum decrease the acute and chronic postoperative pain following cesarean section.  As there are only a few studies done on ultrasound guided transverse abdominis plane block and ultrasound quadratus  lumborum block in cesarean patients, the study is designed to assess the efficacy of ultrasound guided transverse abdominis plane block and quadratus lumborum block for postoperative analgesia following cesarean section.