Transversus Abdominis Plane Block Versus Local Anesthetic Wound Infiltration for Postoperative Analgesia in Adult Patients Undergoing Hernia Repair in Daycare Procedure: A Randomized Control Trial.

Sidra Mukhtar,Insiya Sherawala,Abdul Muqtadir,Fares Mohammed Saeed Muthanna,Estefania Martinez-Jimenez,Hamza Naseem,Shivani M Mehta,Madeha Ishag Adam,Rahil Barkat

doi:10.7759/cureus.21311

Abstract

Introduction: Various modalities are now being used to manage postoperative pain, such as regional nerve blocks techniques, continuous epidural analgesia, patient-controlled analgesia, opioids, and systemic non-steroidal anti-inflammatory drugs. This study compared the mean postoperative pain score between ultrasound-guided transversus abdominis plane (TAP) block and a local anesthetic wound infiltration at the surgical incision site.Methodology: A prospective, comparative, randomized controlled trial (RCT) was carried out from February 2021 to September 2021. The study was conducted in the anesthesia department of Dow University of Health Sciences, Karachi, Pakistan. Patients aged 18-80 years presenting with elective surgery of (both direct and indirect) inguinal hernia repair were enrolled in the study. Participants were randomly assigned into one of the two groups that are local anesthetic wound infiltration (Group A) and TAP block (Group B). The mean pain score was assessed using a visual analog scale and compared between the two groups.Results: The study included 168 patients grouped in two different groups. The mean age in Group A was 43.87 (+17.21), and Group B was 47.01 (±15.37). Mean pain scores in groups A and B were 6.36±1.94 vs 4.51 ± 1.99 (p-value=0.001). The pain rescue medications were given to 57.14% of patients in Group A and 34.52% of patients in Group B, and it was significantly different in the two groups (p-value=0.003). It was found that patients in Group A reported more severe pain (41.67%) than patients in Group B (10.71%).Conclusion: When compared to local anesthetic wound infiltration, ultrasound-guided TAP block had better analgesic activity compared to local anesthetic wound infiltration.

Highlights

Various modalities are being used to manage postoperative pain, such as regional nerve blocks techniques, continuous epidural analgesia, patient-controlled analgesia, opioids, and systemic nonsteroidal anti-inflammatory drugs
The pain rescue medications were given to 57.14% of patients in groups that are local anesthetic wound infiltration (Group A) and 34.52% of patients in Group B, and it was significantly different in the two groups (p-value=0.003)
It was found that patients in Group A reported more severe pain (41.67%) than patients in Group B (10.71%)

Summary

Introduction

Various modalities are being used to manage postoperative pain, such as regional nerve blocks techniques, continuous epidural analgesia, patient-controlled analgesia, opioids, and systemic nonsteroidal anti-inflammatory drugs. Various modalities are being used to manage postoperative pain, such as regional nerve blocks techniques, continuous epidural analgesia, patient-controlled analgesia, opioids, and systemic non-steroidal anti-inflammatory drugs [4]. Transversus abdominis plane (TAP) block is a regional anesthesia technique in which neural afferents to the anterior abdominal wall’s parietal peritoneum, skin, and muscles are blocked to provide analgesia [6]. It blocks T6-L1 lower or mid thoracic and upper lumbar spinal nerves. It is indicated in different surgical procedures to provide analgesia [7]

Methods

Results

Conclusion