scholarly journals EVALUATION OF TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCK WITH INJ.BUPIVACAINE 0.25% FOR POST-OPERATIVE ANALGESIA IN INGUINAL HERNIA REPAIR SURGERY

2020 ◽  
Vol 7 (3) ◽  
pp. 30-37 ◽  
Author(s):  
Niteen Nandanwankar ◽  
Abdullah MF
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Postoperative Analgesia ◽  
Transversus Abdominis ◽  
Control Group ◽  
Tap Block ◽  
Hernia Surgery ◽  
Analgesic Consumption ◽  
Inguinal Hernia Surgery

Background: TransversusAbdominis Plane(TAP)Block is a regional analgesictechnique. It provides postoperative analgesia after lower abdominal surgery. The purpose of our study was to evaluate effectiveness of TAP block to provide effective postoperative analgesia in patients undergoing inguinal hernia repair surgery. Method: Total 60 patients undergoing inguinal hernia surgery were randomized toundergo TAP block with bupivacaine (n = 30) versus normal saline (n = 30)control group. All patients received a standard spinal anaesthesia with standardmonitoring. A TAP block was performed using 20 ml 0.25% bupivacaine on the side ofsurgery or 20 ml saline at the end of surgery. Each patient was followed uppostoperatively at 0, 30 min, 60 min, 2 hr, 4, 6, 8, 12, 18 and 24 hours in PACU. Rescue analgesics inj. Diclofenacwere offered to any patient whocomplained of pain (VAS Score ≥4). Time of rescueanalgesia, total analgesic consumption and any other complications wereassessed. Result : There was a significantly longer time to the first request for rescue analgesic in bupivacaine group. (507.77 ± 10.38 min) compared to NS group.(110.87±14.2min) Total diclofenacconsumptionwas significantly higher in Group S than Group B (82.75 ± 23.2 mg vs193.97 ± 37.6 mg). Conclusion : TAP block provides better postoperative analgesia in patient undergoing inguinalhernia repair surgery . It prolongs the duration of postoperative analgesia and significantly reduces the total analgesic consumption up to 24 hrs postoperatively

Effects of Electroacupuncture on Local Anaesthesia for Inguinal Hernia Repair: A Randomised Placebo-Controlled Trial

2010 ◽  
Vol 28 (2) ◽  
pp. 65-70 ◽  
Author(s):  
Marcio Dias ◽  
Norton Moritz Carneiro ◽  
Luiz Antônio Vanni Guerra ◽  
Guillermo Coca Velarde ◽  
Pedro Assaf Teixeira de Souza ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Local Anaesthesia ◽  
Single Case ◽  
Controlled Trial ◽  
Control Group ◽  
Blood Levels ◽  
Hernia Surgery ◽  
Inguinal Hernia Surgery

Objective To assess the effect of electroacupuncture (EA), akin to percutaneous electroneurostimulation, on pain and biochemical measures during and after inguinal hernia repair. Methods Thirty-three patients were randomised to EA (n=16) or sham transcutaneous electrical nerve stimulation (TENS) control (n=17). EA was applied at different frequencies, through needles inserted around the incision, over selected peripheral nerve branches and in the ear, from 30 min before surgery until the end of surgery, when needles were removed. All patients also received routine sedation and local anaesthesia. Results There was no difference between the pain scores in the groups receiving EA and sham TENS in the immediate postoperative period, which may be owing to adequate levels of analgesia from conventional techniques. On the fourth and seventh postoperative days, less pain and lower consumption of analgesic drugs were reported in the treatment group. Seroma occurred more frequently in the control group, which also had higher glucose blood levels in the immediate postoperative surgery period. The single case of chronic postoperative pain occurred in the control group. Conclusions The sample size was too small to draw any conclusions about the effect of EA on pain and other parameters following inguinal hernia surgery, but our observations suggest that future studies in this area are justified.

Reduction of opioid use using regional anesthetic blocks after inguinal hernia repair in a high risk, safety net population

2021 ◽  
Vol 17 (4) ◽  
pp. 327-335
Author(s):  
Sayeeda Rab, BS ◽  
Sudeepti Vedula, BS ◽  
Aziz M. Merchant, MD, FACS
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Safety Net ◽  
Transversus Abdominis ◽  
University Hospital ◽  
Control Group ◽  
Tap Block ◽  
Significant Difference ◽  
Patient Reported

Objective: The transversus abdominis plane (TAP) block is currently being used perioperatively to reduce postoperative opioid requirements. It is unclear whether TAP blocks reduce postoperative opioid requirements for inguinal hernia repairs. The purpose of this retrospective chart study was to determine whether a TAP block reduces postoperative opioid requirements after an inguinal hernia repair in a safety net hospital.Design: This was a retrospective chart review that evaluated patients at University Hospital in Newark, NJ, who had inguinal hernia repairs from January 2011 to July 2019. Patients were divided into two groups depending on whether they had a TAP block or not. The primary outcome was the amount of opioid required in the first 24 hours postoperatively by a patient reported as morphine equivalent dosing (MED).Results: The group that received the TAP block had a mean (95 percent CI) MED of 7.01 mg (6.70, 7.33), and the control group (no TAP block) had a mean MED of 11.6 mg within 24 hours of the inguinal hernia (p = 0.03). There was no significant difference for postoperative visual analog scale (VAS) pain score, presence of nausea, or length of stay.Conclusions: Patients with TAP block required less morphine equivalence of opioid within a 24 hours period after an inguinal hernia repair.

scholarly journals Ultrasound Guided Transversus Abdominis Plane (TAP) Block versus Caudal Block in Pediatrics Undergoing Inguinal Hernia Repair

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
N M A Fahmy ◽  
A M Hazem ◽  
M A A Tolba ◽  
S A Mostafa
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Surgical Procedures ◽  
Postoperative Analgesia ◽  
Pediatric Patients ◽  
Transversus Abdominis ◽  
Anesthetic Techniques ◽  
Tap Block ◽  
Caudal Block

Abstract Background Inguinal hernia repair is one of the most frequently performed surgical procedures in the pediatric population. Using optimal analgesic regimen provides safe and effective analgesia, reduce postoperative stress response and accelerate recovery from surgery. Regional anesthetic techniques are commonly used to facilitate pain control in pediatric surgical procedures. The most commonly used techniques in pediatrics are caudal block and TAP block. Objective This study was to compare the effectiveness and safety of US guided TAP block versus caudal block as a part of multimodal analgesia in pediatric patients undergoing inguinal hernia repair. Patients and Methods The study was conducted on 90 randomly chosen patients in Ain Shams University Hospitals after approval of the Medical Ethical Committee. Patients were divided randomly into two groups, each group consisted of 45 patients. After preoperative assessment and obtaining baseline vital data, all patients received general anesthesia. Results The results of the study revealed that US guided TAP block provided significantly prolonged postoperative analgesia, reduced the postoperative analgesic requirements and better parents’ satisfaction as compared with caudal block in pediatric patients undergoing inguinal hernia. Both analgesic techniques are safe. Conclusion The current study revealed that US guided TAP block provided significantly prolonged postoperative analgesia, reduced the postoperative analgesic requirements and better parents’ satisfaction as compared with caudal block in pediatric patients undergoing inguinal hernia. Both analgesic techniques are safe.

Comparison between Ultrasound Guided Transversus Abdominis Plane Block versus Ultrasound Guided IlioInguinal/Iliohypogastric Nerves Block for Postoperative Analgesia in Patients Undergoing Unilateral Oblique Inguinal Hernia Repair Under General Anesthesia

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Shrouk Ayman Mohamed Soliman Faramawy ◽  
Samia Abdel-Mohsen Abdel-Latif ◽  
Mohamed Abdel-Salam Menshawe Abdel-Atte ◽  
Ibrahim Mohammed El Sayed Ahmed
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
General Anesthesia ◽  
Inguinal Hernia Repair ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Ultrasound Guided ◽  
Rescue Analgesia ◽  
Pain Scores

Abstract Background Inguinal hernia considered the third common disease in surgeries for adults after acute appendicitis and proctologic disorders. About 20 millions of inguinal hernia repairs are performed globally. Inguinal herniorrhaphy is frequently associated with persistent postoperative pain. Objectives The aim of this study is to assess the postoperative analgesic efficacy of transversus abdominis plane (TAP) block compared to ilioinguinal/iliohypogastric nerves block after unilateral inguinal hernia repair regarding the pain relief, effect on hemodynamics, requirement of first supplemental doses of analgesia and total number of doses received. Patients and Methods The study was conducted on 70 randomly chosen patients aged 21 to 60 years, American Society of Anesthesiologists (ASA) class I or II scheduled for elective unilateral open inguinal hernia repair under general anesthesia, in Ain Shams University Hospitals after approval of the medical ethical committee. Results The results of the study revealed that there is Patients receiving TAP block had significantly lower pain scores at 4 h and 6 h after operation, delay time for rescue analgesia and decrease total need of analgesic in first 24 h post operative compared with patients who received ilioinguinal/ iliohypogastric nerves block. Conclusion TAP block was effective in reducing postoperative pain scores for 4-6 hours, lowering total 24-h postoperative opioid and analgesic consumption and delaying the need for rescue analgesia after inguinal hernia repair under general anesthesia, compared to ilioinguinal/iliohypogastric nerves block. This technique can be a promising mode of postoperative analgesia when epidural catheter insertion is contraindicated.

scholarly journals Efficacy of Transversus Abdominis Plane Block and Rectus Sheath Block in Laparoscopic Inguinal Hernia Surgery

2015 ◽  
Vol 100 (4) ◽  
pp. 666-671 ◽  
Author(s):  
Katsushi Takebayashi ◽  
Masakata Matsumura ◽  
Yasuhiro Kawai ◽  
Takahiko Hoashi ◽  
Nagato Katsura ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Rectus Sheath ◽  
Transversus Abdominis ◽  
Block Group ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Hernia Surgery ◽  
Laparoscopic Inguinal Hernia ◽  
Inguinal Hernia Surgery

We aimed to assess the efficacy of transversus abdominis plane (TAP) block and rectus sheath (RS) block in patients undergoing laparoscopic inguinal hernia surgery. Few studies have addressed the efficacy and safety associated with TAP block and RS block for laparoscopic surgery. Thirty-two patients underwent laparoscopic inguinal hernia surgery, either with TAP and RS block (Block+ group, n = 18) or without peripheral nerve block (Block− group, n = 14). Preoperatively, TAP and RS block were performed through ultrasound guidance. We evaluated postoperative pain control and patient outcomes. The mean postoperative hospital stays were 1.56 days (Block+ group) and 2.07 days (Block− group; range, 1–3 days in both groups; P = 0.0038). A total of 11 patients and 1 patient underwent day surgery in the Block+ and Block− groups, respectively (P = 0.0012). Good postoperative pain control was more commonly observed in the Block+ group than in the Block− group (P = 0.011). TAP and RS block was effective in reducing postoperative pain and was associated with a fast recovery in patients undergoing laparoscopic inguinal hernia surgery.

scholarly journals SEROMA AFTER TENSION-FREE INGUINAL HERNIA REPAIR – OUR EXPERIENCE

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Vinod Kumar Nigam ◽  
Siddarth Nigam
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Dead Space ◽  
Hernia Surgery ◽  
Tension Free ◽  
Body Tissues ◽  
Inguinal Hernia Surgery ◽  
Tissue Dissection ◽  
Low Incidence

Seroma Is a collection of fluid called serum that gets collected at the site of inguinal hernia surgery. It is common after inguinal hernia repair with a mesh. Usually seroma develops after 7 to 10 day of operation but can develop even earlier depending upon the amount of tissue dissection. More the dissection more the chances of development of seroma. The fluid in seroma is usually clear or straw colored. Seroma generally does not require any treatment; it disappears by absorption by body tissues within few weeks. Large seromas may require repeated aspiration. To avoid developing seroma after inguinal hernia surgery is to do minimal tissue dissection and avoid dead space formation. We operated 400 cases of inguinal hernia by a modified Lichtenstein tension-free procedure called NICH (Nigam’s inverted curtain hernioplasty) our incidence of development of seroma was 1.5% against international incidence of 7% which is a real low incidence. We have discussed the ways to avoid formation of seroma after open inguinal hernioplasty. Keywords: dead space, dissection, inguinal hernia, Lichtenstein, mesh, NICH, seroma.

scholarly journals Effect of Addition of Dexamethasone or Clonidine to Ropivacaine on Postoperative Analgesia in Ultrasonography Guided Transversus Abdominis Plane Block for Inguinal Hernia Repair: A Prospective Double Blind Randomized Control Trial

2020 ◽  
Vol 5 (1) ◽  
pp. 74-77
Author(s):  
Sweta Bharadiya ◽  
Neelam Meena ◽  
Ram Nivas ◽  
R.K. Solanki
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Visual Analog Scale ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Analog Scale ◽  
Rescue Analgesia

Background: A hernia repair surgery commonly induces moderate to severe postoperative pain for 48 hours. Aim of the study was to compare 0.5% Ropivacaine with dexamethasone and 0.5% Ropivacaine with clonidine for ultrasonography guided transversus abdominis plane (TAP) block as post-operative analgesia in patients undergoing Inguinal hernia repair surgery.Subjects and Methods:A randomized prospective controlled clinical study was conducted in 64 patients undergoing Inguinal Herneoplasty. Participants were divided into two groups in which group RD (n=32) received 0.5% Ropivavacaine with Dexamethasone 8mg and those in group RC (n=32) received 0.5% Ropivacaine with Clonidine 75mcg as USG guided TAP block at the end of surgery. The postoperative pain was evaluated by visual analog scale (VAS) for pain scoring at every 2 hours for 24 hours postoperatively. Subjective assessment of duration of analgesia was done.Results:Time to first rescue analgesia was significantly less in group RC (424.53±34.13) compared to group RD (616.09±31.36min) (P < 0.001). Total tramadol consumed in 24 h was significantly higher in group RC than group RD (P < 0.001). Visual analog scale scores for both somatic and visceral pain were significantly higher in group RC than group RD at 6h, 8 h and 12 h postoperatively.Conclusion:TAP block is a safe and effective way of relieving postoperative pain in inguinal herneoplasty patients. Addition of dexamethasone to Ropivacaine significantly enhances its effect in terms of block quality and analgesia duration as compared to clonidine addition.

scholarly journals Inguinal hernia repair in inpatient children: a nationwide analysis of German administrative data

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Andreas Heydweiller ◽  
Ralf Kurz ◽  
Arne Schröder ◽  
Christina Oetzmann von Sochaczewski
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Administrative Data ◽  
Large Scale ◽  
Paediatric Surgery ◽  
Open Approach ◽  
Hernia Surgery ◽  
Inguinal Hernia Surgery ◽  
Over Time

Abstract Background Contrary to adult inguinal hernia surgery, large-scale investigations using registries or administrative data are missing in paediatric surgery. We aimed to fill this gap by analysing German administrative hospital data to describe the current reality of inpatient hernia surgery in children. Methods We analysed aggregated data files bought from the German federals statistics office on hospital reimbursement data separately for principal diagnoses of inguinal hernia in children and for herniotomies in inpatients. Developments over time were assessed via regression and differences between groups with nonparametric comparisons. Results Principal diagnoses of hernias were decreasing over time with the exception of male bilateral and female bilateral incarcerated hernias in the first year of life which increased. The vast majority of operations were conducted via the open approach and laparoscopy was increasingly only used for females older than 1 year of age. Recurrent hernia repair was scarce. Rates of inguinal hernia repair were higher in both sexes the younger the patient was, but were also decreasing in all age groups despite a population growth since 2012. The amount of inguinal hernia repairs by paediatric surgeons compared to adult surgeons increased by 1.5% per year. Conclusions Our results corroborate previous findings of age and sex distribution. It demonstrates that inpatient hernia repair is primarily open surgery with herniorrhaphy and that recurrences seem to be rare. We observed decreasing rates of hernia repairs over time and as this has been described before in England, future studies should try to elucidate this development. Level of evidence III.

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