Ultrasound guided Transverses Abdominal Plane Block versus Ilioinguinal/iliohypogastric Nerve Blocks for Postoperative Analgesia in Infants Undergoing Lower Abdominal Surgery

Background Pediatric patients undergo a variety of lower abdominalsurgical procedures that need adequate pain relief perioperatively. Ultrasound guided lioinguinal/iliohypogastric nerve blockade and TAB block are common peripheral nerve block techniques used to alleviate pain in pediatric anesthesia. Ultrasound guidance, promote the visualization of important anatomy and can help overcome many of the traditional obstacles of in advert important structures injury in infant’s delicate soft tissues when performing these blocks. Objectives To compare the efficacy of TAP blocks versus lioinguinal/iliohypogastric nerve blockade on postoperative analgesia requirements after lower abdominal surgery. Patients and Methods Sixty children who were scheduled to undergo unilateral lower abdominal surgery were enrolled in this study. The patients were randomized into US guided TAB Group (Group T) and US guided lioinguinal/iliohypogastric nerve blocks (Group I). The surgery was allowed to start about 20 minutes after performance of the block. The children were assessed every 30 minutes in recovery room until discharge from the hospital. Postoperative analgesia was measured using (CHEOPS). The number of children who needed postoperative rescue analgesics and the duration of analgesia that was taken at the time when an analgesic was required were recorded. Presence of significant muscle weakness was assessed at 3 hours after the block. Main Results 5 participants were excluded from the study, No significant differences were found between two groups as regard patients’ characteristics, type of surgeries or duration of anesthesia. The average pain score during hospital stay for group T and group I showed no statistically significant difference all over the study except at 240 minutes after surgery it was significantly lower in group (T) when compared to group (I). The average time to first rescue analgesia and the duration of analgesia was longer in group (T) as compared to group (I). In recovery room, no differences were found between two groups as regard analgesic medication in PACU, analgesic medication at day-stay unit or at home, total dose of analgesics medication, incidence of PONV or any motor weakness. Authors’ Conclusions TAP block is an easy regional nerve block technique that provides postoperative pain relief for longer duration as compared to ilioinguinal/iliohypogastric nerve blockade.