Comparison of Ultrasound-Guided Transversalis Fascia Plane Block, Quadratus Lumborum Block, and Ilioinguinal-Iliohypogastric Block for Postoperative Analgesia in Cesarean Section
DOI:
https://doi.org/10.63682/jns.v14i8.7789Keywords:
N\AAbstract
Background: Postoperative pain is a common complication after caesarean section (CS), and its management is essential to prevent adverse perioperative outcomes. Well-managed postoperative analgesia improves patient comfort while encouraging early ambulation and breastfeeding. This study aims to compare the analgesic efficacy of transversal fascial plane block (TFPB) vs. quadratus lumborum block (QLB) vs. Ilioinguinal Iliohypogastric (ILIH) block in patients undergoing caesarean section under neuraxial anaesthesia.
Methods And Materials: In this randomized clinical trial, 90 patients undergoing elective CS under spinal anesthesia were randomly allocated to receive TFPB or QL, or ILIH block under ultrasound guidance after surgery. The severity of pain was assessed using Visual Analogue Scale (VAS) during rest at 0, 2, 4, 6, 12, and 24 hours after surgery, time to first analgesic request, and dosage of analgesic use and complications were compared between groups.
Results: The cumulative paracetamol consumption over 24 hours was 1 gram for the QL group, 1 to 1.5 grams for the TFP group, and > 2 grams for the ILIH group. The median paracetamol consumption at 12 hours and 16 hours was also lower in the QL group compared to the TFP and ILIH groups (P <0.05). There was no statistically significant difference between groups regarding time to first analgesia request (p >0.05). The pain scores at 18 hours and 24 hours were lower in the QL group compared to the TFP and ILIH groups, respectively (p <0.05). There is no statistically significant difference between groups regarding the postoperative side effects and complications.
Conclusion: In all three QLB, TFPB had comparable high analgesic efficacy during the first 24 hours. QL block had longer analgesic effectiveness compared to TFPB and ILIH block, with an effect lasting for 18- 24 hours.
Downloads
Metrics
References
Carvalho VH, Azi LMTA, de Carvalho LIM, Schmidt AP. Obstetric anesthesia: pearls and pitfalls in anesthesia for cesarean delivery. Braz J Anesthesiol. 2022;72:441–3.
Sultan P, Halpern SH, Pushpanathan E, Patel S, Carvalho B. The effect of intrathecal morphine dose on outcomes after elective cesarean delivery: a meta-analysis. Anesth Analg. 2016;123:154–64.
Bilgin S, Aygun H, Genc C, et al. Comparison of ultrasound-guided transversalis fascia plane block and anterior quadratus lumborum block in patients undergoing caesarean delivery: a randomized study. BMC Anesthesiol. 2023;23:246.
Sripriya R, Janani G, Sivashanmugam T. Comparison of ultrasound-guided transversalis fascia and posterior transversus abdominis plane block for postoperative analgesia following caesarean delivery: A double-blinded randomised controlled trial. Indian J Anaesth. 2023;67(10).
Yetneberk T, Chekol B, Teshome D. The efficacy of TAP block versus ilioinguinal block for post-cesarean section pain management: A systematic review and meta-analysis. Heliyon. 2021;7(8):e07774.
Gultekin A, Yavru A, Akinci SB, et al. Comparison of ultrasound-guided transversalis fascia plane block and no block for postoperative analgesia after cesarean delivery: a randomized controlled trial. J Clin Anesth. 2023;85:111080. doi:10.1016/j.jclinane.2023.111080
Kim N, Brull R, Chan VWS, et al. Quadratus lumborum block for postoperative pain management: A meta-analysis. Anesth Analg. 2021;132(3):636–645. doi:10.1213/ANE.0000000000005253
Salama ER, Elkady MA, Gaber NM. Efficacy of posterior quadratus lumborum block versus intrathecal morphine for pain relief after cesarean delivery. Egypt J Anaesth. 2020;36(1):35–42. doi:10.4103/ejanes.ejanes_89_19
Irwin R, Anwari JS, Hayek M, et al. Analgesic efficacy of quadratus lumborum block versus intrathecal morphine for elective cesarean delivery: a randomized controlled trial. Anesth Essays Res. 2019;13(4):681–686. doi:10.4103/aer.AER_103_19
Zahoor MU, Rauf A, Asghar A, et al. Comparison of transversalis fascia plane block and ilioinguinal-iliohypogastric nerve block for postoperative analgesia after cesarean section: a randomized controlled trial. Cureus. 2023;15(5):e38840. doi:10.7759/cureus.38840
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
