The transversus abdominis plane block may reduce early postoperative pain after laparoscopic ventral hernia repair: A matched pair analysis

Paasch, Christoph; Aljedani, N.; Ortiz, Pedro; Azarhoush, S.; Fiebelkorn, J.; Boettge, K.A.; Gauger, Ulrich; Anders, S.; Santo, Gianluca De; Strik, M. W.

doi:10.1016/j.amsu.2020.05.044

Cited by 4 publications

(4 citation statements)

References 24 publications

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“…Two prospective randomized clinical trials (n = 80, laparoscopic ventral hernia repair in IPOM technique) revealed a significant pain reduction effect within 24 h after surgery [ 22 , 23 ]. On the contrary to that, our study group and Fields et al (2015) did not detect an IVG-TAP block impact on early postoperative pain and analgesic use [ 21 , 24 ]. The authors performed a randomized trial among 100 individuals who underwent laparoscopic ventral hernia repair in IPOM technique.…”

Section: Discussioncontrasting

confidence: 99%

“…Hence, we reviewed the literature for the TAP block use prior to laparoscopic ventral hernia repair. Our search yielded three relevant publications including a matched pair analysis (n = 52) on our own [ 21 ]. Two prospective randomized clinical trials (n = 80, laparoscopic ventral hernia repair in IPOM technique) revealed a significant pain reduction effect within 24 h after surgery [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound-versus visual-guided transversus abdominis plane block prior to transabdominal preperitoneal ingunial hernia repair. A retrospective cohort study

Paasch

Fiebelkorn

Santo

et al. 2020

Annals of Medicine and Surgery

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Background The transversus abdominis plane block is a regional anesthesia technique. Recently, its impact on early chronic pain and the cumulative need of analgesic medication following inguinal hernia repair is being monitored. In terms of effectiveness and patient safety, it remains unclear whether the approach should be conducted preoperatively through ultrasound guidance, or through intraoperative visual guidance.The study at hand aims to provide more evidence on this topic. Methods A monocentric retrospective matched pair analysis was performed. The intraoperative visual guided and ultrasound guided -transversus abdominis plane block prior to inguinal hernia repair in transabdominal preperitoneal technique were consecutively compared in regard to analgesic effectiveness and complication rate. The data of individuals who were operated on from June 2007 to February 2019 were analyzed. The matching criteria were ASA-Score, Gender, Age ( ±6 years), and hernia size (<1,5 cm, 1,5-3 cm, >1,5 cm). Results A total of 116 patients were enrolled. Both groups were homogenous in terms of age, gender contribution, body mass index, ASA-Score, hernia type, and size. The pain score at the postoperative anesthesia care unit was lower in the ultrasound-guided-transversus abdominis plane group without being statistically significant (VAS-Score: 0.67 vs.0.84). Patients of the ultrasound-guided-transversus abdominis plane group received significantly less metamizole on the day of operation (1.29 g (0.96) vs. 1.68 g (0.70), p = 0.015). Conclusion Due to our findings, we assume that the ultrasound-guided-transversus abdominis plane -Block may reduce postoperative pain and analgesic consumption more effectively than the visual-guided-transversus abdominis plane lock. Further prospective clinical trials are mandatory.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Ultrasound-versus visual-guided transversus abdominis plane block prior to transabdominal preperitoneal ingunial hernia repair. A retrospective cohort study

Paasch

Fiebelkorn

Santo

et al. 2020

Annals of Medicine and Surgery

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“…Similar results were discussed by Sinha et al [7], Jain et al [8], Bhatia et al [9], and Paash et al [10]. In contrast to Karamanos et al [11], we found that epidural analgesia resulted in a statistically significant decrease in postoperative pain levels on POD 0 instead of 1, but only in the IPOM group.…”

Section: Discussionsupporting

confidence: 91%

TAP Block Prior to Open Ventral Hernia Repair Improves Surgical Outcome

2022

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Background Ventral hernias commonly affect patients after major abdominal surgery. To reduce postoperative pain, the effects of the transversus abdominis plane (TAP) block, epidural analgesia and medication-only protocol have been investigated. The primary outcome was the cumulative dosage of opioids (morphine milligram equivalents MME), of acetaminophen and diclofenac for postoperative pain control on postoperative day (POD) 0, 1, and 2. Secondary outcomes were length of stay (LOS) and the pain scale rating using the numeric rating scale (NRS) on POD 0, 1, and 2. Methods The data were retrospectively extracted from the charts of the patients admitted for a surgical operation for OVHR from January 2015 to December 2019. Results Patients receiving medication-only analgesia had longer LOS (mean 6.1 days; p < 0.00001). Cumulative opioid consumption was significantly lower at 24 and 48 h after surgery in the TAP block group than in the other groups (mean MME 1.9 mg and 0.7 mg, respectively; p < 0.05). The cumulative consumption of diclofenac was significantly lower in the TAP block group than in the others (44.1 mg; p ≤ 0.00001 on POD 1; 4.4 mg; p = 0.03 on POD 2). TAP block is more effective in pain control in POD 0 (mean NRS 5.4; p < 0.00001), POD 1 (mean NRS 6.1; p = 0.006), and POD 2 (mean NRS 4.9; p = 0.001) if it is performed after adopting the retromuscular technique. Conclusions The comparison between the medication-only technique, epidural, and TAP block demonstrated the superiority of the last one for the aims considered in this study.

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“…Additionally, a prospective RCT with 70 patients who had VHR demonstrated that a TAP block could reduce pain [51,54]. Paasch et al [55] reported that in some patients, the TAP block performed before laparoscopic VH surgery may lessen early postoperative pain and analgesic prescription use.…”

Section: In-hospital Pain After Ipom Plus With Tap Blockmentioning

confidence: 99%

Ventral hernia repair in India: a Delphi consensus

Chowbey,

Wadhawan,

Subramanian

et al. 2024

Hernia

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Purpose While research on inguinal hernias is well-documented, ventral/incisional hernias still require investigation. In India, opinions on laparoscopic ventral hernia repair (LVHR) techniques are contested. The current consensus aims to standardize LVHR practice and identify gaps and unfulfilled demands that compromise patient safety and therapeutic outcomes. Methods Using the modified Delphi technique, panel of 14 experts (general surgeons) came to a consensus. Two rounds of consensus were conducted online. An advisory board meeting was held for the third round, wherein survey results were discussed and the final statements were decided with supporting clinical evidence. Results Experts recommended intraperitoneal onlay mesh (IPOM) plus/trans-abdominal retromuscular/extended totally extraperitoneal/mini- or less-open sublay operation/transabdominal preperitoneal/trans-abdominal partial extra-peritoneal/subcutaneous onlay laparoscopic approach/laparoscopic intracorporeal rectus aponeuroplasty as valid minimal access surgery (MAS) options for ventral hernia (VH). Intraperitoneal repair technique is the preferred MAS procedure for primary umbilical hernia < 4 cm without diastasis; incisional hernia in the presence of a vertical single midline incision; symptomatic hernia, BMI > 40 kg/m2, and defect up to 4 cm; and for MAS VH surgery with grade 3/4 American Society of Anaesthesiologists. IPOM plus is the preferred MAS procedure for midline incisional hernia of width < 4 cm in patients with a previous laparotomy. Extraperitoneal repair technique is the preferred MAS procedure for L3 hernia < 4 cm; midline hernias < 4 cm with diastasis; and M5 hernia. Conclusion The consensus statements will help standardize LVHR practices, improve decision-making, and provide guidance on MAS in VHR in the Indian scenario.

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The transversus abdominis plane block may reduce early postoperative pain after laparoscopic ventral hernia repair: A matched pair analysis

Cited by 4 publications

References 24 publications

Ultrasound-versus visual-guided transversus abdominis plane block prior to transabdominal preperitoneal ingunial hernia repair. A retrospective cohort study

Ultrasound-versus visual-guided transversus abdominis plane block prior to transabdominal preperitoneal ingunial hernia repair. A retrospective cohort study

TAP Block Prior to Open Ventral Hernia Repair Improves Surgical Outcome

Ventral hernia repair in India: a Delphi consensus

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