The analgesic effect of ultrasound-guided transverse abdominis plane block after laparoscopic totally extraperitoneal hernia repair

Abstract

BackgroundThe ultrasound-guided transverse abdominis plane block (TAPB) reduces postoperative pain after laparoscopic abdominal surgery. But, its effect post laparoscopic totally extraperitoneal hernia repair (TEP) is not clear. In this study, we evaluated the analgesic effect of ultrasound-guided TAPB in TEP.MethodsIn this prospective, randomized study, forty adult patients (ASA I-II) scheduled for a TEP under general anesthesia were studied. In the TAPB group (n = 20), an ultrasound-guided bilateral TAPB was performed with 0.375% ropivacaine 15 ml on each side after the induction of general anesthesia. The control group (n = 20) did not have TAPB performed. Fentanyl 50 µg was repeatedly injected as per the patient's request in the recovery room. Pain scores at rest and on coughing were assessed postoperatively in the recovery room (20 min, at discharge) and at 4, 8, and 24 hours after surgery.ResultsIn the recovery room, pain scores (numeric rating scale, 0-10) at postoperative 20 min were lower in the TAPB group (3.9 ± 1.6, 4.9 ± 1.8) than the control group (6.9 ± 1.6, 8.0 ± 1.6) at rest and on coughing. Also, pain scores upon discharge from the recovery room were lower in the TAPB group (3.2 ± 1.2, 4.2 ± 1.5) than the control group (5.3 ± 1.6, 6.5 ± 1.8) at rest and on coughing.ConclusionsThe ultrasound-guided TAPB in patients that had undergone TEP reduced postoperative pain scores and the fentanyl requirement in the recovery room. Also, pain scores on coughing were reduced until postoperative 8 hours.

Laparoscopic-assisted transversus abdominis plane block as an effective analgesic in total extraperitoneal inguinal hernia repair: a double-blind, randomized controlled trial

“…The efficacy of ultrasound-guided TAP block and rectus sheath block has been previously investigated in laparoscopic inguinal hernia repair [ 12 – 14 ]. To the best of our knowledge, laparoscopic-assisted TAP block has not been utilized or evaluated prospectively in laparoscopic total extraperitoneal (TEP) repair of inguinal hernia as a component of multi-modal analgesia.…”

The Analgesic Efficacy of Ultrasound-Guided Transversus Abdominis Plane Block in Adult Patients

“…3,45,48,53,54,57,61,[63][64][65]68 In 4 trials, data were approximated from median and range. 43,44,55,56 Ultrasound-guided TAP block was combined with general anesthesia in 25 trials (80%), [2][3][4]7,[42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61]68 with spinal anesthesia and intrathecal long-acting opioid in 3 trials (10%), [64][65][66] or with spinal anesthesia and intrathecal short-acting opioid in 3 trials (10%). 62,63,67 The volume of local anesthetic used per side varied between 12 mL 47 and 30 mL 7 with a total dose of bupivacaine equivalent ranging from 60 mg 47 to 214 mg. 52 Three trials combined the local anesthetic with epinephrine, 7,48,57 whereas 1 trial adm...…”

“…43 Ultrasound-guided TAP block was performed before the surgery in 18 trials (58%). [2][3][4]7,42,43,[46][47][48]50,51,[53][54][55][56]58,59,61 The approach was subcostal in 2 trials (6%), 7,61 lateral in 18 trials (58%), 3,[42][43][44][45][47][48][49][50]52,58,59,[62][63][64][65][66]68 posterior in 8 trials (26%), 2,4,46,51,55,56,60,67 and was not specified in 3 trials (10%). 53,57,61 With the exception of 3 trials, 53,54,61 where it was not specified, the authors pe...…”

“…Atim et al, 42 Baaj et al, 62 Bollag et al, 64 Costello et al, 65 De Oliviera et al, 56 Elkaradawy, 43 Gasanova et al, 44 Griffiths et al, 45 Kane et al, 57 Khan et al, 47 Kim et al, 58 Melnikov et al, 48 Parikh et al, 49 Petersen et al, 59 Petersen et al, 50 Ra et al, 4 Shin et al, 51 Singh et al, 66 Skjelsager et al, 52 Tan et al, 68 Tsuchiya et al, 53 Walter et al, 61 Atim et al, 42 Bollag et al, 64 Costello et al, 65 Gasanova et al, 44 Griffiths et al, 45 Kim et al, 58 Melnikov et al, 48 Parikh et al, 49 Petersen et al, 59 Petersen et al, 50 Shin et al, 51 Singh et al, 66 Tan et al, 68 Walter et al, 61 Wu et al Atim et al, 42 Baaj et al, 62 Belavy et al, 63 Costello et al, 65 De Oliviera et al, 55 De Oliviera et al, 56 El-Dawlatly et al, 2 Elkaradawy, 43 Gasanova et al, 44 Griffiths et al, …”

An Evaluation of the Adding Magnesium Sulfate to Ropivacaine on Ultrasound-Guided Transverse Abdominis Plane Block After Abdominal Hysterectomy

“…The effect of local anesthetic infusion on the abdominal wall is investigated in connection with analgesia induction in healthy people and with postoperative pain management in cesarean section and inguinal hernia repair, which produced different results ( 29 - 32 ). Thus, employing other techniques, rather than catheterization, seems necessary to prolong the duration of the effect of TAP block.…”