TAP block in inguinal hernia repair. Randomized controlled trial

  • Oscar David Aguirre-Ospina Hospital Servicios Especiales de Salud, Manizales, Colombia
  • Juan Camilo Gómez-Sálgado Surgery Department, Universidad de Caldas, Manizales, Colombia
  • Doris Chaverra Surgery Department, Universidad de Caldas, Manizales, Colombia
  • Mauricio Alzate Surgery Department, Universidad de Caldas, Manizales, Colombia
  • Ángela María Ríos-Medina Surgery Department, Universidad de Caldas, Manizales, Colombia
Keywords: Anesthesia, Conduction, Acute pain, Hernia, Inguinal, Postoperative pain, Nerve block

Abstract

Introduction:

Around the world, inguinal hernia repair is one of the most frequent surgical interventions and is associated with moderate to severe postoperative pain. TAP (Transver-sus Abdominis Plane) block appears to be a useful tool to reduce the morbidity associated with pain in inguinal hernia repair.

Objective:

To evaluate the analgesic effect of a TAP block in patients scheduled for primary inguinal hernia repair, 1 h and 24-h post-surgery.

Materials and Methods:

Randomized controlled trial. 45 patients were randomized to receive placebo vs. TAP block. Clinical, surgical and anesthetic variables were analyzed. The primary outcome was pain in the first hour and the secondary outcome was pain during the first 24 h, opiate use and side effects.

Results:

The acute postoperative pain score during the first hour in the control group was 6 with maximum values of 9 in 22% of patients, whereas in the intervention group the pain score was 2 (SD: 1) (p: 0.03). Likewise, pain 24 h postop and opiate consumption was lower in the intervention group than in the control group.

Conclusions:

TAP block helps to reduce acute postoperative pain and the use of opiates in inguinal hernia repair.

References

1. Zib M, Gani J. Inguinal hernia repair: where to next? ANZ J Surg. 2002;72:573-9.

2. Torregrosza L, Pulido H, Rogeles S, Henao F. Herniorrafia inguinal: diez años de seguimiento. Rev Colomb Cir. 2001;16:197-201.

3. Joshi GP, Rawal N, Kehlet H, PROSPECT collaboration, Bonnet F, Camu F, et al. Evidence-based management of postoperative pain in adults undergoing open inguinal hernia surgery. Br J Surg. 2012;99:168-85.

4. Awad SS, Fagan SP. Current approaches to inguinal hernia repair. Am J Surg. 2004;188 Suppl.:9S-16S.

5. Siddiqui MR, Sajid MS, Uncles DR, Cheek L, Baig MK. A meta-analysis on the clinical effectiveness of transversus abdominis plane block. J Clin Anesth. 2011;23:7-14.

6. McDonnell JG, O'Donnell B, Curley G, Heffernan A, Power C, Laffey JG. The analgesic efficacy of transversus abdominis plane block after abdominal surgery: a prospective randomized controlled trial. Anesth Analg. 2007;104:193-7 [Erratum in: Anesth Analg. 2007;104(5):1108].

7. Abdallah FW, Chan VW, Brull R. Transversus abdominis plane block: a systematic review. Reg Anesth Pain Med. 2012;37:193-209.

8. El-Dawlatly AA, Turkistani A, Kettner SC, Machata AM, Delvi MB, Thallaj A, et al. Ultrasound-guided transversus abdominis plane block: description of a new technique and comparison with conventional systemic analgesia during laparoscopic cholecystectomy. Br J Anaesth. 2009;102:763-7.

9. Petersen PL, Mathiesen O, Stjernholm P, Kristiansen VB, Torup H, Hansen EG, et al. The effect of transversus abdominis plane block or local anaesthetic infiltration in inguinal hernia repair: a randomised clinical trial. Eur J Anaesthesiol. 2013;30:415-21.

10. Quintana JE. Aplicaciones de la ecografía perioperatoria y de cuidado crítico. Rev Colomb Anestesiol. 2014;42:114-6.

11. Carney J, Finnerty O, Rauf J, Bergin D, Laffey JG, Mc Donnell JG. Studies on the spread of local anaesthetic solution in transversus abdominis plane blocks. Anaesthesia. 2011;66:1023-30.

12. Finnerty O, Sharkey A, Mc Donnell JG. Transversus abdominis plane block for abdominal surgery. Minerva Anestesiol. 2013;79:1415-22.

13. Flatters SJ. Characterization of a model of persistent postoperative pain evoked by skin/muscle incision and retraction (SMIR). Pain. 2008;135(1-2):119-30.

14. Gritsenko K, Khelemsky Y, Kaye AD, Vadivelu N, Urman RD. Multimodal therapy in perioperative analgesia. Best Pract Res Clin Anaesthesiol. 2014;28:59-79.

15. López BV, Caballero JG, Ramón JM, Grande PA, Sebastián JD, Jiménez AC. Atención del dolor postoperatorio en un hospital de tercer nivel: situación inicial previa a la implantación de un programa de calidad. Rev Esp Anestesiol Reanim. 2006;53:408-18.

16. Viscusi ER, Pappagallo M. A review of opioids for in-hospital pain management. Hosp Pract (1995). 2012;40:149-59.

17. Venkatraman R, Abhinaya RJ, Sakthivel A, Sivarajan G. Efficacy of ultrasound-guided transversus abdominis plane block for postoperative analgesia in patients undergoing inguinal hernia repair. Local Reg Anesth. 2016;9: 7-12.

18. Milone M, Di Minno MN Musella M, Maietta P, Salvatore G, Iacovazzo C, et al. Outpatient inguinal hernia repair under local anaesthesia: feasibility and efficacy of ultrasound-guided transversus abdominis plane block. Hernia. 2013;17:749-55.
How to Cite
1.
Aguirre-Ospina OD, Gómez-Sálgado JC, Chaverra D, Alzate M, Ríos-Medina Ángela M. TAP block in inguinal hernia repair. Randomized controlled trial. Colomb. J. Anesthesiol. [Internet]. 2017 Jul. 1 [cited 2024 Apr. 19];45(3):159-65. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/296

Downloads

Download data is not yet available.
Published
2017-07-01
How to Cite
1.
Aguirre-Ospina OD, Gómez-Sálgado JC, Chaverra D, Alzate M, Ríos-Medina Ángela M. TAP block in inguinal hernia repair. Randomized controlled trial. Colomb. J. Anesthesiol. [Internet]. 2017 Jul. 1 [cited 2024 Apr. 19];45(3):159-65. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/296
Section
Original

Altmetric

Article metrics
Abstract views
Galley vies
PDF Views
HTML views
Other views
QR Code

Some similar items: