Ultrasound Guided Transversus Abdominis Plane (TAP) Block is Better Than Local Wound Infiltration for Postoperative Pain Management in Inguinal Hernia Repair. | [Anaesthesia, Pain and Intensive Care • 2015]

Author(s):

1. Muhammad Tahseen Talib: Masters Critical Care Medicine, Postgraduate Trainee Anesthesia, PIMS, Islamabad, Pakistan

2. Rana Imran Sikander: Department of Anesthesia, PIMS, Islamabad, Pakistan

3. Muhammad Faheem Ahsan: Department of General Surgery PIMS, Islamabad, Pakistan

Abstract:

Background & Objective: Transversus abdominis plane (TAP) block has been shown to provide good postoperative pain relief following various abdominal and inguinal surgeries. We evaluated the effectiveness of ultrasound guided TAP block against conventional local anesthetic wound infiltration for better postoperative analgesia in patients undergoing inguinal hernia repair. Methodology: This prospective randomized controlled study was conducted after approval from ethical review board. A total of 100 adult male patients, American Society of Anesthesiologists (ASA) physical status 1 or 2 were randomized either to Group I (TAP) (n = 50) receiving ultrasound guided TAP block with 0.5% bupivacaine 1.5 mg/kg or Group II (LAI) (n = 50) receiving similar dose as conventional local anesthetic wound infiltration. Inj. tramadol was used as rescue analgesic if needed. Pain score was recorded by visual analogue scale (VAS) on emergence, then 2 hourly for 8 hours followed by 4 hourly for 24 hours postoperatively. Mean pain score, total dose of rescue analgesic/24 hours and procedure related complications, including postoperative nausea / vomiting, were recorded. Results: There was no significant difference between the baseline characteristics of both groups. Mean pain scores in Group I (TAP) and II (LAI) were 2.1 ± 1.2 and 4.8 ± 1.5 respectively (P < 0.001) and corresponding opiate requirement was significantly less in Group I (TAP) 17.2 ± 68.4 mg of tramadol vs 136.4 ± 86.3mg of tramadol in Group II (LAI) (P < 0.001). Nausea / vomiting were observed in 21.7 vs. 78.3% of patients in Group I (TAP) and Group II (LAI) respectively. No procedure related complications were noted in any patient. Conclusion: Ultrasound guided TAP block is found to be safe and an effective modality of providing postoperative analgesia with significantly less post-operative nausea vomiting and opiate requirement when compared to local anesthetic wound infiltration.

Page(s): 457-462

DOI: DOI not available

Published: Journal: Anaesthesia, Pain and Intensive Care, Volume: 19, Issue: 4, Year: 2015

Keywords:

Keywords are not available for this article.

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