INTERFASCIAL PLANE BLOCKS IN OBSTETRIC AND GYNECOLOGIC SURGERY/INTERFASCIJALNI BLOKOVI U PORODNISTVU I GINEKOLOSKOJ KIRURGIJI

Introduction: Interfascial plane blocks (IPB) are truncal blocks with local anesthetic injected into space between two muscle layers. IPBs are easy to learn, simple to perform, provide satisfactory analgesia up to 24 hours, having a minimal risk of complications. Methods: We present a retrospective analysis of the patients who had IPB as a part of postoperative pain management plan following either CD or hysterectomy in Leskovac General Hospital, Serbia during the period April 2017 - February 2022. Results: We had 131 patients who had IPB perioperatively. Bilateral QLB type 1 was performed in S3 patients after CD and in 68 patients after hysterectomy. Bilateral ESPB T10-11 was done following one CD case and in 9 patients before hysterectomy. Patients had both acetaminophen and nonsteroidal anti-inflammatory drug for postoperative pain control. Decreased usage of fentanyl and sevoflurane was noticed in the cases where IPB was performed preoperatively. Almost all patients had well-controlled pain, and were very satisfied with pain score of 0-4/10 at numeric rating scale during 24 hours after surgery, with no opioid use. There were no complications regarding block performance. Conclusion: QLB and ESPB have great potential to improve and facilitate postoperative pain management in obstetric and gynecologic surgery. Keywords: quadrafus lumborum plane block, QLB, erector spinae plane block, ESPB, Cesarean delivery, hysterectomy Uvod: Interfascijalniblokovi (Interfascial plane block, IPB) su blokovi trupa koji se izvode ubrizgavanjem lokalnog anestetika u prostor izmedu dva sloja misica. Laid su za ucenje, jednostavni za izvodenje, omogucuju analgeziju u trajanju do 24 sata. Metode: Ovo je retrospektivna analiza pacijentica koje su perioperativno dobile IPB, a bile podvrgnute carskom rezu ill histerektomiji u Opcoj bolnici Leskovac (Srbija) tijekom perioda travnja 2017 - veljace 2022. Rezultati: IPB perioperativno dobila je ukupno 131 pacijentica. Bilateralni kvadratus lumborum blok (quadratus lumborum blok, QLB) izveden je kod S3 pacijentice nakon carskogreza, i kod 68 pacijentica nakon histerektomije. Bilateralni erektor spine blok (erector spinae plane block, ESPB) T10-11 izveden je kod jedne pacijentice nakon carskog reza i kod 9 pacijentica neposredno prije histerektomije. Za postoperativnu kontrolu bola koristeni su paracetamol i nesteroidni antiupalni lijekovi. Smanjena upotreba fentanila i sevoflurana zabiljezena je kod osoba koje su blok dobile preoperat