Ultrasound-Guided Ilioinguinal/Iliohypogastric Nerve Block versus Ultrasound Guided Transversus Abdominis Plane Block for Lower Abdominal Surgeries: A comparative Clinical Study

Abstract

Background: Effective pain relief is of utmost importance to anyone undergoing surgery. Postoperative pain relief increases patient comfort and satisfaction. This is best accomplished with a multi-modal approach. Recent trends in minimally invasive surgery and improved recovery protocols have addressed pain treatment in light of these goals. Aim of the work: Comparison between ultrasound-guided Ilioinguinal and Iliohypogastric nerve block with ultrasound-guided transversus abdominis plane block regarding postoperative analgesia in patients scheduled for lower abdominal surgeries. Patients and methods: Seventy patients of ASA I or II, aged 21-50 years, who planned for elective open lower abdominal surgeries were included. They signed an informed consent and were randomly classified into two groups: [Group I] scheduled for Ilioinguinal and Iliohypogastric nerve block, and [Group II] scheduled for transversus abdominis plane block guided by ultrasound. Postoperative pain assessment was conducted by numerical rating score. Results:In inguinal hernia repair, pain score at rest was significantly reduced in the TAP group when compared to Group-I at 30 minutes till the seventh hour postoperatively and at 12 up to 15 hours postoperatively. Also, in the CS group, the pain score was significantly decreased in TAP block when compared to nerve block at 90, 105 minutes, and from 4 up to seventh postoperative hours. With movement, pain scores were significantly lower at the 4, 5, 6, 7, 8, 9, 10, and 11 -hours in group II in inguinal hernia. It was significantly decreased at the 90 minutes to 2 -hours in group II in the CS subgroup. The total analgesic requirements were significantly lower in group II. Conclusion: Ultrasound-guided TAP block tended to be more effective than Ultrasound-guided II/IH nerve block in lowering postoperative pain scores and decreasing the need for rescue analgesia in lower abdominal surgeries.

Keywords

• ilioinguinal
• iliohypogastric
• transversus abdominis plane
• lower abdominal
• surgery