Intermittent Transcutaneous Electrical Nerve Stimulation versus Transversus Abdominis Plane Block for Postoperative Analgesia after Infraumbilical Surgeries

BACKGROUND: Multimodal analgesia is currently recommended for effective postoperative analgesia. AIM: The aim of this study is to compare the efficacy of transversus abdominis plane (TAP) block with intermittent transcutaneous electrical nerve stimulation (TENS) in postoperative patients after infraumbilical surgeries under spinal anesthesia with respect to postoperative analgesia, rescue analgesia, hemodynamic changes, block characteristics, nausea/vomiting score, sedation score, adverse effects, and patient satisfaction. SETTINGS AND DESIGN: This was a prospective, observational study randomized controlled trial. METHODS: A total of 60 American Society of Anesthesiologists physical status Classes I and II patients of 20–60 years scheduled for infraumbilical surgeries were randomized by a computer-generated list into two groups of 30 each, to receive either TAP Block (Group TAP: 15 ml of 0.25% levobupivacaine on each side of abdomen) or TENS (Group TENS: TENS with frequency of 50 Hz and intensity of electrical stimulation 9–12 mA, continued for 30 min every 2 h till 24 h). The primary outcome was to compare the postoperative analgesia as assessed using visual analog scale score. Secondary objectives were to compare rescue analgesia, nausea/vomiting score, sedation score, the block characteristics, adverse effects, hemodynamic changes, and patient satisfaction. STATISTICAL ANALYSIS USED: Student's t-test, Chi-square test as applicable and Statistical Package for Social Sciences (version 23.0, 2017, SPSS Inc., Chicago, IL, USA) were used. RESULTS: Time to the first analgesic requirement was 12.87 ± 4.72 h in Group TAP and 9.93 ± 3.63 h in Group TENS (P < 0.008), the difference between two groups was significant. CONCLUSION: TAP block is better modality due to ease of application and prolonged analgesia.