A comparative study between the analgesic effects of ultrasound guided bilateral ilioinguinal / iliohypogastric nerve block and bilateral transverses abdominis plane block after caesarean section: A Randomized control clinical trial

Objectives: The aim of this work was to contrast the analgesic effect of sonar guided Ilioinguinal/Iloypogastric nerve (IL) block and Transverse abdominis plane (TAP) block after CS.Methods: This randomized control clinical trial had been conducted on 90 adult participants ranging in age from 21 to 35 years old with ASA II undergoing CS. Patients were allocated in three groups equally. Group I (Control Group) obtained spinal anesthesia only, Group II (Ilio-Inguinal Ilio Hypogastric (IL-IH) nerve block) received spinal anesthesia with bilateral ultrasound (US) IL- IH nerve block (After skin closure (Total 20ml bupivacaine 0.25%) for each side and Group III (TAP block) received spinal anesthesia with bilateral US TAP block (After baby delivery & skin closure) (Total 20 ml bupivacaine 0.25%) for each side.Results: VAS was insignificantly different at 2 and 24 hr. among the three groups but was significantly different at 6, 12 and 18 hr. across the three groups (P value <0.001). VAS was significantly lower at 6 and 18 hr. in (ILIH group and TAP group) contrasted to in Control group (P value <0.001). It was insignificantly varied between ILIH group and TAP group. At 12 hr. it had been significantly higher in ILIH and TAP groups than in control group (P value <0.001) and it was significantly lower in TAP than ILIH group (P value <0.001). Time to 1st rescue analgesia was 6±0 in spinal group, 12±0 in ILIH group and 12±0 in TAP group. A significant increase in analgesic use exited in control & IL-IH groups compared to TAP group.Conclusions: US guided IL-IH block is an analgesic substitute method to TAP block in female participants having cesarean section. Similar analgesic use, haemodynamic stability, and drug-related side effects were seen between the two blocks.