Abstract
Background: Pain is one of the most common compliant and cause of distress in the perioperative period. The postoperative pain after cesarean section is believed to be of mild to moderate intensity lasting for up to 72 hours. Apart from patient preferences, number of factors affect choices of analgesia in a resource limited setting like Ethiopia. Availability of resources, a trained man power and inter-individual variation in pain threshold were among a factor affecting analgesia choices. Thus, this study aims to compare TAP block versus II/IH block for post cesarean delivery analgesia in resource limited areas where ultrasound guided block is not practiced.Method: A randomized controlled trial study were conducted in Dilla University teaching and referral Hospital found in southern Ethiopia. A pregnant women scheduled for elective cesarean section was randomized to either TAP block (n = 36) or II/IH block (n = 36) for postoperative pain management. Sample size were calculated using a G-power version 3.1.9.2 getting a total of 72 participants. Pain severity, total tramadol consumption and time to first analgesia request were asses’ during the first 72 hour postoperatively. Many Whitney U-test and independent t-test were used based on distribution of data. A Kaplan Meier analysis was to asses’ proportion of patients who did not require analgesia for 48hour follow up period.Result: The cumulative median tramadol consumption over 48hour were 100 mg for TAP group and 150 mg for II/IH (p = 0.018). The median tramadol consumption at 24hr. and 36 hr. were also lower in TAP group compared to II-IH (P < 0.05). There is no statistically significant difference between groups regarding time to first analgesia request (p > 0.05). The median pain score at 36hr. and 48hr. were lower in TAP group (3 and 4) compared to II-IH group (4 and 6) respectively (p < 0.05). There is no statistically significant difference between groups regarding the postoperative side effects and complication.Conclusion: Both II-IH and TAP block has comparable analgesic efficacy during the first 24hr. TAP block has a longer analgesic effectiveness compared to II-IH with an effect lasting for 48hr.
Comparison of bilateral ilioinguinal-iliohypogastric nerve block versus transverses abdominis nerve block for postoperative pain management for parturient undergoing elective cesarean section in Dilla University Referral Hospital, Ethiopia. A randomized controlled trial
