Laparoscopic-guided distal loco-regional anesthetic infiltration technique in TAPP inguinal hernia repair: a double-blind randomized clinical trial

Viñas, José F; Díaz, E; Scaravonati, Rodolfo; Oberwittler, Dietrich; Brandi, Claudio; Campana, Juan Pablo; Bertone, Santiago

doi:10.1007/s00464-021-08775-6

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…The use of local anesthesia is surgeon dependent at our institution and has occurred in 37% of procedures in this study. Interestingly, there was a trend towards greater local anesthetic use in those who requested an opioid refill, which is counterintuitive as randomized studies show improvement in post-operative pain control with the use of local anesthesia for LIHR [ 36 , 37 ]. Prescription of other non-opioid oral pain medications at discharge is not standardized at our institution and is surgeon and resident dependent.…”

Section: Discussionmentioning

confidence: 99%

Opioid prescribing practices and patient-requested refill patterns following laparoscopic inguinal hernia repair

Gentle

Thomas

Montelione

et al. 2022

Hernia

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Purpose Excessive post-operative opioid prescribing has led to efforts to match prescriptions with patient need after surgery. We investigated opioid prescribing practices, rate of patient-requested opioid refills, and associated factors after laparoscopic inguinal hernia repair (LIHR). Methods LIHRs at a single institution from 3/2019 to 3/2021 were queried from the Abdominal Core Health Quality Collaborative for demographics, perioperative details, and patient-reported opioid usage. Opioid prescriptions at discharge and opioid refills were extracted from the medical record. Univariate and multivariable regression were used to identify factors associated with opioid refills within 30-days of surgery. Results Four hundred and ninety LIHR patients were analyzed. The median number of opioid tablets prescribed was 12 [interquartile range (IQR) 10–15], and 4% requested a refill. On univariate analysis, patients who requested refills were younger [55 years (IQR 37–61) vs. 62 years (IQR 36.8–61), p = 0.012], more likely to have undergone transabdominal preperitoneal repair (75% vs. 26.4%, p < 0.001), have a scrotal component (30% vs. 11%, p = 0.022), and have permanent tacks used (80% vs. 49.4%, p = 0.014). There was a 12% increase in the odds of opioid refill for every 1 tablet of oxycodone prescribed at discharge (95% CI for OR 1.04–1.21, p = 0.003) after controlling for age and surgery type. Patient-reported opioid use was available for 289 (59%) patients. Post-operatively, 67% of patients used ≤ 4 opioid tablets, and 87% used no more than 10 opioid tablets. Conclusion Most patients use fewer opioid tablets than prescribed. Requests for opioid refills are rare following LIHR (4%) and associated with higher opioid prescribing.

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Section: Discussionmentioning

confidence: 99%

Opioid prescribing practices and patient-requested refill patterns following laparoscopic inguinal hernia repair

Gentle

Thomas

Montelione

et al. 2022

Hernia

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“…[17,18] Regional block anesthesia (RBA) is also a popular technique for IHR, which involves the administration of anesthetic drugs to the local dominating nerve roots to avoid complications of SA. [19,20] Previous studies have investigated the effectiveness of RBA in patients with IHR. [20][21][22][23][24] However, no systematic review has yet explored this topic.…”

Section: Introductionmentioning

confidence: 99%

Regional block anesthesia for adult patients with inguinal hernia repair: A systematic review

Zhang

Zeng

et al. 2022

Medicine

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Background: Inguinal hernia repair (IHR) is a common surgical technique performed under regional block anesthesia (RBA). Although previous clinical trials have explored the effectiveness and safety of RBA for IHR, no systematic review has investigated its effectiveness and safety in adult patients with IHR.Methods: This systematic review searched electronic databases (PubMed, Embase, Cochrane Library, CNKI, Wangfang, and VIP) from their inception to July 1, 2022. We included all potential randomized controlled trials that focused on the effects and safety of RBA in adult patients with IHR. Outcomes included operative time, total rescue analgesics, numerical rating scale at 24 hours, occurrence rate of nausea and vomiting, and occurrence rate of urinary retention (ORUCR).Results: Five randomized controlled trials, involving 347 patients with IHR, were included in this study. Meta-analysis results showed that no significant differences were identified on operative time (MD = −0.20; fixed 95% confidence interval [CI], −3.87, 3.47; P = .92; I² = 0%), total rescue analgesics (MD = −8.90; fixed 95% CI, −20.36, 2.56; P = .13; I² = 28%), and occurrence rate of nausea and vomiting (MD = 0.39; fixed 95% CI, 0.13, 1.16; P = .09; I² = 0%) between 2 types of anesthesias. However, significant differences were detected in the numerical rating scale at 24 hours (MD = −1.53; random 95% CI, −2.35, −0.71; P < .001; I² = 75%) and ORUCR (MD = 0.20; fixed 95% CI, 0.05, 0.80; P = .02; I² = 0%) between the 2 management groups. Conclusion:The results of this study demonstrated that IHR patients with RBA benefit more from post-surgery pain relief at 24h and a decrease in the ORUCR than those with CSA.Abbreviations: CI = confidence interval, IH = inguinal hernia, IHR = inguinal hernia repair, MD = mean difference, NRS at 24 hours = numerical rating scale at 24 hours, NV = occurrence rate of nausea and vomiting, ORUCR = occurrence rate of urinary retention, OT = operative time, RBA = regional block anesthesia, RCTs = randomized controlled trials, SA = spinal anesthesia, TRA = total rescue analgesics.

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Transversus abdominis plane blocks in laparoscopic inguinal hernia repair: a review

Hubbard

Hubert

Vudayagiri

et al. 2023

Hernia

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Laparoscopic-guided distal loco-regional anesthetic infiltration technique in TAPP inguinal hernia repair: a double-blind randomized clinical trial

Cited by 3 publications

References 27 publications

Opioid prescribing practices and patient-requested refill patterns following laparoscopic inguinal hernia repair

Opioid prescribing practices and patient-requested refill patterns following laparoscopic inguinal hernia repair

Regional block anesthesia for adult patients with inguinal hernia repair: A systematic review

Transversus abdominis plane blocks in laparoscopic inguinal hernia repair: a review

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