Comparison of Transversus Abdominis Plane Block versus Local Wound Infiltration in Reducing Postoperative Pain in Patients Undergoing Infraumblical Hernia Repair

Abstract

Objective: To compare the outcomes of TAP block versus local wound infiltration in reducing postoperative pain in patients undergoing infra-umbilical hernia repair. Study design: Randomized controlled trial Place and Duration of Study: Department of Anaesthesiology, Surgical Intensive Care Unit & Pain Management, Dow Medical College & Civil Hospital Karachi from 1st August 2020 to 31st January 2021. Methodology: One hundred patients with undergoing infra-umbilical hernia mesh repair were randomly allocated into two groups. Fifty patients in group A were treated with transversus abdominis plane block and 50 were in group B for local infiltration. Anaesthetic technique was standardized. The drug was administered according to the weight of the patient. Visual analogue score (VAS), graduated from 0-10 was recorded. Results: The mean age was 41.08±10.36 years. There were 61% males and 39% females. Mean time of analgesia was significantly high in group A than groups B [413.2±63.83 vs 274.16±41.28; p=0.0005]. Mean VAS pain score at rest and movement was also significantly low in group A than group B. Conclusion: Transversus abdominis plane block seemed preferable to local anesthetic wound infiltration in postoperative analgesia. Current evidence is insufficient to suggest that the transversus abdominis plane block will minimize post-operative morphine requirements and associated side effects in comparison with local anesthetic infiltration. Key Words: Hernia repair, Transversus abdominis plane (TAP) block, Local wound infiltration, Postoperative morphine