TRANSVERSES ABDOMINIS PLANE BLOCK VERSUS QUADRATUS LUMBORUM BLOCK FOR POSTOPERATIVE ANALGESIA AFTER CAESAREAN SECTION.

Abstract

BACKGROUND- Caesarean section for baby delivery is one of the most common surgical procedures being performed worldwide. Effective early postoperative analgesia remains priority and it can improve maternal outcome. Multimodal analgesia remains standard for post operative analgesia following caesarean section. Truncal block, including transversus abdominis plane (TAP) block and quadratus lumborum block play an important roles in multimodal analgesia. Aim of this study was to compare TAP block versus QL block for analgesic efciency after cesarean section under general anaesthesia. METHODS – This prospective randomized control study was done in tertiary care hospital from June 2021 to December 202, 80 patients were enrolled and randomized into two groups TAPB and QLB group with 40 patients each. Ultrasound guided TAP block and QL block with 20 ml of 0.2% Ropivacaine was given on each side was given postoperatively before extubation. Patients were observed for 24 hours, Inj Tramadol intravenous was given as rescue analgesia. Patients were evaluated for analgesic efciency, time to rescue analgesia, number of doses, average analgesic dose were noted along with median VAS score.RESULTS- Average dose requirement for rescue analgesia was higher in TAPB group than QLB group. Number of patients requiring analgesia was 80% in TAPB and 27.5% in QLB group. Time to rescue analgesia was 820 minutes in TAPB group and 1414 minutes in QLB group. Median VAS scores were comparable between two groups initially; signicant difference was seen at 6 hours postoperatively, with maximum difference seen at 12 hours interval. Beyond 18 hours difference in median VAS scores between two groups was insignicant. No complications with either of procedures were noted.CONCLUSIONS - Analgesic efcacy of QL block is better than TAP block. Median VAS scores were lower and time to rst analgesic demand was prolonged, with reduced total analgesic consumption in 24 hours.