Transversus abdominis plane block versus local anesthetic wound infiltration in patients undergoing open inguinal hernia repair surgery

Abstract

Objectives This study aimed to compare the analgesic effect of ultrasound-guided transversus abdominis plane (TAP) block versus wound infiltration in patients undergoing open inguinal hernia repair. Patients and methods A total of 60 male patients scheduled for open unilateral inguinal hernia repair under general anesthesia were randomly allocated into two equal groups: group W received wound infiltration with 0.2 ml/kg of 0.25% levobupivacaine at the site of incision, and group T received ultrasound-guided TAP block with 0.5 ml/kg of 0.25% levobupivacaine. Time to first analgesic request, total morphine requirement over 24 h, and visual analogue pain score at rest and during cough were assessed over the course of 24 h. Results Total morphine requirement during the first 24 h was significantly less in group T. A total of 21 patients in group W required supplemental morphine compared with 13 patients in group T. Time to first analgesic request was significantly longer in group T. Patients receiving TAP block had significantly lower pain scores at rest for 12 h and on cough for 6 h after operation when compared with patients who received wound infiltration. Conclusion TAP block provided more reliable and effective analgesia and less total 24-h postoperative morphine consumption compared with wound infiltration with the local anesthetic.