THE ANALGESIC EFFECT OF ULTRASOUND-GUIDED TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCK FOR LAPAROSCOPIC BILATERAL INGUINAL HERNIA REPAIR

Abstract

Background: Transversus abdominis plane (TAP) block is a (new) regional anesthetic technique that provides analgesia to the parietal peritoneum, as well as the skin and muscles of the anterior abdominal wall, by introducing local anesthetic into the neuro-fascial plane between the internal oblique and the transversus abdominis muscles. Pain after laparoscopic bilateral inguinal hernia surgery can be moderate to severe and can result in prolonged hospital stay, unanticipated hospital admission and delayed return to normal daily activities. We evaluated the efficacy of TAP block in patients undergoing laparoscopic bilateral inguinal hernia repair in a randomized controlled clinical trial. Material and methods: Sixty patients undergoing laparoscopic bilateral inguinal hernia repair were randomized to undergo standard care (n=30) or to undergo a bilateral TAP block with bupivacaine (n=30). All patients received standard anesthetic, and after induction of anesthesia, the TAP group received an ultrasound-guided bilateral TAP block. Each patient was assessed after operation at 2, 6, 12 and 24 hours after surgery. Results: Bilateral ultrasound-guided TAP block significantly reduced postoperative visual analogue scale (VAS) pain scores at rest and on moving, reduced ketonal and tramadol postoperative consumption and reduced incidence of PONV in the TAP block group after surgery compared to control group. Conclusion: Bilateral ultrasound-guided TAP block provides effective postoperative analgesia during the 24 postoperative hours after laparoscopic bilateral inguinal hernia repair.