Linea Semilunaris Block for Post Cesarean Section Pain Relief: An Effective Multimodal Analgesia Technique

Background : Pain relief is the right of every patient undergoing surgery and more so of any parturient post cesarean delivery because she has to take care of her baby also. So this multimodal analgesia technique of linea semilunaris block with intrathecal buprenorphine was studied to see its efficacy for post cesarean section analgesia. Methods : A prospective randomized comparative study conducted in 60 ASA grade 2 and 3 pregnant women aged 20-40 years requiring LSCS under spinal anesthesia - divided into 2 groups of 30 patients each. Intervention groups: Group 1 - bilateral open surgical linea-semilunaris block with injection 0.2% ropivacaine 20 ml with 1 ml normal saline on either side of abdomen, Group 2 - bilateral open surgical linea-semilunaris block with injection 0.2% ropivacaine 20 ml with dexamethasone 4 mg on either side of abdomen. Results : The duration of analgesia, demand for first rescue analgesia was prolonged in both the groups. The total demand of postoperative analgesics and nausea and vomiting was reduced significantly, postoperative mobilization was very fast in both the groups. Conclusions: Linea semilunaris block with intrathecal opioid is an effective multimodal analgesia combination for post LSCS pain. It is an open surgical technique, easy and safe to perform under vision, does not require any costly gadgets, very cost effective, opioid sparing and reduces the consumption of postoperative analgesics with fast recovery, early mobilization and high patient satisfaction. We recommend this multimodal analgesia technique for post caesarean section and lower abdominal surgeries.