[COMPARISON OF THE EFFECTIVENESS OF ILIOINGUINAL-ILIOHYPOGASTRIC BLOCKADE AND TRANSVERSUS ABDOMINIS PLANE BLOCK FOR...

Area of Science:

• Anesthesiology
• Pain Management
• Obstetrics

Background:

• Postoperative pain after cesarean delivery can be effectively managed with regional anesthesia techniques.
• Ultrasound-guided nerve blocks are increasingly utilized for targeted pain relief.
• Comparing the efficacy of different abdominal wall blocks is crucial for optimizing patient outcomes.

Purpose of the Study:

• To compare the analgesic efficacy of ilioinguinal-iliohypogastric nerve block versus transversus abdominis plane block after cesarean delivery.
• To evaluate pain scores, hormonal stress response, and opioid consumption in patients receiving either block.
• To determine which block offers superior pain management following suprapubic laparotomy cesarean delivery.

Main Methods:

• Prospective randomized study involving 164 healthy women undergoing elective cesarean delivery under spinal anesthesia.
• Ultrasound-guided ilioinguinal-iliohypogastric nerve block (10 ml 0.5% ropivacaine each side) or transversus abdominis plane block (20 ml 0.25% ropivacaine) administered postoperatively.
• Pain assessment using Visual Analogue Scale (VAS) at rest and during movement at multiple time points (3, 6, 9, 12, 24 hours).
• Monitoring of serum cortisol and glucose levels, and tramadol consumption and adverse effects.

Main Results:

• Both ilioinguinal-iliohypogastric nerve block and transversus abdominis plane block significantly improved postoperative analgesia.
• The ilioinguinal-iliohypogastric nerve block demonstrated greater analgesic efficacy compared to the transversus abdominis plane block.
• No significant differences were noted in cortisol and glucose levels between the groups, but tramadol consumption was lower in the ilioinguinal-iliohypogastric group.

Conclusions:

• Ultrasound-guided ilioinguinal-iliohypogastric nerve block is a more effective method for postoperative analgesia after cesarean delivery compared to transversus abdominis plane block.
• Both techniques provide valuable pain relief, contributing to better recovery and reduced opioid requirements.
• Further research may explore optimal ropivacaine concentrations and volumes for these blocks in obstetric anesthesia.