Randomised control trial to evaluate post-operative analgesia efficacy of USG guided transverse abdominis plane (TAP) block with ropivacaine (0.5%) in unilateral hernia surgery by total requirement of diclofenac as post-operative analgesia drug

Abstract

Background: Inguinal hernia repair is a common surgical procedure. Chronic pain occurs in 5-10% after the inguinal hernia repair. This study is aimed to evaluate post-operative analgesia efficacy of ultrasound guided transverse abdominal plane (TAP) block in unilateral hernia surgery. Aims and Objective: The present study aimed to evaluate the post-operative pain scoring at ½, 2,4,6,12,18 and 24 hours duration on basis of pain intensity using Visual Analogue Scale (VAS). Total requirement of analgesic drug in first 24 hours. To compare time for first rescue analgesia. Material and Method: A total of 80(n=80) patients of ASA I and II grade in the age group of 20 to 65 years undergoing unilateral hernia surgery. They were randomized into two groups. Lumbar puncture was done at L3-L4 space through a standard 25 G quincke spinal needle in sitting position of patient. Drug 0.5% hyperbaric bupivacaine 3.5 ml was administered intrathecally as a single dose in all patient. Study group: Patients received TAP block with Ropivacaine (0.5%) 20 ml after completion of surgery. Control group: Patients not received TAP block and was given injection diclofenac on demand for postoperative analgesia. The primary outcome was measured as patient-reported pain intensity using VAS. Results: VAS score was significantly lower in study group post‑operatively at all time intervals(P<0.0001). The 24‑h diclofenac consumption was significantly less in study group compared to control group (93.7±32.88mg vs. 204.3±44.89 mg, P< 0.0001). Time for first rescue analgesia was significantly more in study group as compared to control group (635.66±312.2 minutes vs. 210±140.7 minutes, p<0.0001).Conclusion: TAP block provided excellent post‑operative analgesia in the first 24 h.