Comparison of Ultrasound Guided Transversus Abdominis Plane Block versus Local Wound Infiltration for Post Operative Analgesia in Patients Undergoing Inguinal Hernia or Infra Umbilical Incisional Hernia

Abstract

Background: since the concept of day case surgeries are getting more popular, surgeons and anesthesiologists are trying their best to provide adequate post operative analgesia. The proper management of post operative pain ensures early ambulation of patients and obviates many postoperative complications. Aim of the Work: to compare the efficacy of transversus abdominis plane (TAP) block versus wound infiltration with local anesthetic agent as regarding postoperative analgesia, its effect on hemodynamic changes (HR, BP) during rest, opioid (pethidine) consumption. The patients included in this study were either of inguinal hernia or infra umbilical incisional hernia. Patients and Methods: after obtaining approval from the medical ethical committee in Ain Shams University, this prospective randomized clinical trial study was conducted in Ain Shams University Hospital. It included fifty adult undergoing inguinal hernia or infra umbilical incisional hernia repair. Results: patients were assigned randomly into two equal groups: Group A: (n = 25) TAP Block: patients received general anesthesia followed by Tap block at the end of the operation. Group B: (n=25) Local Wound Infiltration: patients received general anesthesia followed by local wound infiltration at the end of the operation. Conclusion: bilateral TAP block was effective in reducing postoperative pain scores at rest and movement for 8-12 hours and lower total 24-h postoperative opioid and analgesic consumption after inguinal hernia or infra umbilical incisional hernia repair under general anesthesia, compared to local wound infiltration. This technique can be a promising mode of postoperative analgesia where epidural catheter insertion is contraindicated.