Efficacy of Bilateral Transverse Abdominis Plane Block and Ilioinguinal Iliohypogastric Nerve Block for Post Lower Segment Caesarean Section Pain Relief: A Randomised Clinical Study

Introduction: Insufficient pain management postcaesarean section causes maternal distress, which impacts mother-infant bonding and breastfeeding. Improving postoperative analgesia not only enhances patient satisfaction but also shortens hospital stay, reduces pulmonary complications, supports early mobilisation and decreases the risk of thromboembolism. Aim: To compare the efficacy of bilateral Transverse Abdominis Plane block (TAP) and Ilioinguinal Iliohypogastric block (II-IH) for postcaesarean section pain relief. Materials and Methods: A randomised clinical study was conducted at Dhiraj Hospital, Piparia, Vadodara, Gujarat, India, on 60 pregnant women, aged between 18 to 45 years, who were posted for elective Lower Segment Caesarean Section (LSCS). They were randomised into Group T (n=30) for TAP block or Group I (n=30) for II-IH block. Both groups received 20 mL of 0.25% bupivacaine on both sides. Patients were assessed for Visual Analogue Score (VAS), pulse rate, blood pressure and oxygen saturation at 1, 2, 4, 6, 8, 10, 12, and 24 hours postoperatively. The duration of analgesia, total analgesic consumption and complications were also noted. Rescue analgesia was administered if VAS was >3, in the form of 75 mg i.v. diclofenac. Data were analysed using the sample t-test and repeated measures Analysis of Variance (ANOVA) test. A p-value of <0.05 was considered significant. Results: Both groups were comparable in terms of demographic data (age, weight, height, Body Mass Index (BMI)) with a p-value of >0.05. The VAS score was not statistically significant for 24 hours postoperatively between the two groups with p>0.05 at each time point. The mean duration of analgesia was 606 +/- 35.24 minutes in Group T and 702 +/- 40.86 minutes in Group I, which was statistically significant (p-value=0.04). Total i.v. diclofenac consumption was 105 +/- 62.07 and 75 +/- 45.49 in Groups T and I, respectively, which was statistically significant (p-value=0.014). Pulse rate, blood pressure and oxygen saturation were comparable in both groups with no significant difference at any time point. No complications were encountered in either group. Conclusion: Both TAP block and II-IH block are safe and provide analgesia to parturients postoperatively. However, the II-IH block provides a longer duration of analgesia and reduces the postoperative intravenous analgesic requirement compared to the TAP block.