Korean J Anesthesiol.  2012 Sep;63(3):227-232. 10.4097/kjae.2012.63.3.227.

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

• Kim MG
• Kim SI
• Ok SY
• Kim SH
• Lee SJ
• Park SY
• Lee SM
• Jung BI

• KMID: 2236272
• DOI: http://doi.org/10.4097/kjae.2012.63.3.227

Abstract

BACKGROUND
The 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.
METHODS
In 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 microg 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.
RESULTS
In 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.
CONCLUSIONS
The 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.

Keyword

Herniorrhaphy; Laparoscopy; Ropivacaine; Transverse abdominis plane block; Ultrasonography

MeSH Terms

Adult
Amides
Anesthesia, General
Benzamidines
Cough
Fentanyl
Hernia
Herniorrhaphy
Humans
Laparoscopy
Pain, Postoperative
Prospective Studies
Pyrazines
Recovery Room
Amides
Benzamidines
Fentanyl
Pyrazines