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Comparison of Analgesic Efficacy of Transversus Abdominis Plane Block with Ilioinguinal Iliohypogastric Nerve Block in Lower Abdominal Surgeries under Spinal Anesthesia: A Double Blind Randomized Study

Archana Agarwal , Shruti Sharma , Archana Agarwal , Trilok Chand , Priyanka Singh , Ankur Saxena

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Indian Journal of Anesthesia and Analgesia 6(6):p 2194-2200, November-December 2019. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6619.50

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Shruti Sharma, Archana Agarwal, Trilok Chand et al. Comparison of Analgesic Efficacy of Transversus Abdominis Plane Block with Ilioinguinal Iliohypogastric Nerve Block in Lower Abdominal Surgeries under Spinal Anesthesia: A Double Blind Randomized Study. Indian J Anesth Analg. 2019;6(6 Part - II):2194-2200.

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Abstract

Background: Regional blocks of the anterior abdominal wall have proven to be highly effective in providing excellent postoperative analgesia, decreasing opioid requirements and facilitating early mobilization and discharge after lower abdominal surgeries. In our study, we compared Transversus Abdominis Plane (TAP) block and Ilioinguinal/iliohypogastric block (IL/IH) for postoperative analgesia in lower abdominal surgeries. Materials and Methods: After local ethical committee approval and written consent, the double blind prospective randomized study was conducted on 116 patients (Type I error of 0.05 and a power of 0.9, a sample size of 44 patients/group) of ASA Grade I-II undergoing lower abdominal surgeries under spinal anesthesia. Patients were randomly divided into two Groups through computer generated sequence: Group T: Bilateral TAP block and Group I: Bilateral IL/IH block. Patients were assessed postoperatively for tramadol requirement, first analgesic demand, postoperative pain using Verbal Analog Score (VAS), nausea, vomiting and sedation. Statistical analysis was done by SPSS software version 20 (SPSS Inc., Chicago, IL, USA) and Student’s t - test, Mann-whitney U test and Fisher’s exact test applied. (p – value < 0.05 significant). Results: Demographic data were comparable. Tramadol requirement (primary outcome) was lesser in Group T as compared to Group I (p < 0.001), time for first analgesic dose was greater in Group T. Group T expressed significantly lesser VAS scores at 4, 12, and 24 hours. Postoperative nausea & vomiting was reduced in Group T as compared to Group I but was statistically insignificant. Patient satisfaction was greater in Group T. Conclusion: Transversus Abdominis Plane block provided better pain control than ilioinguinal-iliohypogastric block in lower abdominal surgeries.

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Shruti Sharma, Archana Agarwal, Trilok Chand et al. Comparison of Analgesic Efficacy of Transversus Abdominis Plane Block with Ilioinguinal Iliohypogastric Nerve Block in Lower Abdominal Surgeries under Spinal Anesthesia: A Double Blind Randomized Study. Indian J Anesth Analg. 2019;6(6 Part - II):2194-2200.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6619.50

Keywords

TAP Block; Ilioinguinal-Iliohypogastric block; Bupivacaine; tramadol.

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