Comparison between ultrasound-guided transversus abdominis plane block and conventional ilioinguinal/iliohypogastric nerve block as post-operative analgesia for unilateral open inguinal hernioplasty under spinal anaesthesia
Journal Title: Medpulse International Journal of Anesthesiology - Year 2018, Vol 6, Issue 3
Abstract
Background: Open inguinal hernioplasty is commonly performed under spinal anesthesia. Transversus Abdominis Plane (TAP) block or ilioinguinal/iliohypogastric (IHN) block are used for postoperative pain relief in these patients. Ultrasound guided TAP blocks have better success rates. Aims and Objectives: To compare the efficacy, duration and quality of post operative analgesia between ultrasound guided TAP block and conventional IHN block after unilateral open inguinal hernioplasty under spinal anesthesia with 0.5% heavy Bupivacaine. To assess the safety of both techniques by comparing the side-effects and complications when used for post-operative pain relief. Material and Methods: After obtaining institutional ethical committee approval, total 60 adult patients of both sexes of ASA I-III undergoing open unilateral inguinal hernioplasty under spinal anesthesia with 0.5% heavy Bupivacaine were selected for the study. Patients were randomly divided in two groups, Group A (n=30) received ultrasound-guided TAP block with 20 ml 0.25% Bupivacaine while Group B (n=30) received conventional IHN block with 20ml of 0.25% Bupivacaine; both for post-operative analgesia. During post operative period other than vital parameters, quality of analgesia was assessed by Visual Analogue Scale (VAS) and time of rescue analgesia was noted. Patients were also monitored for side-effects like nausea and vomiting and complications associated with the blocks. Results: Duration of analgesia in post-operative period for group A was prolonged as compared to group B. Quality of analgesia evidenced by mean VAS scores was better with group A. No side-effects or complications were noted in both the groups. However in one case failure of ilioinguinal/iliohypogastric block was noted. Conclusion: Compared to conventional IHN block, ultrasound-guided TAP block is more effective for post-operative analgesia.
Authors and Affiliations
Madhuja Kanbarkar, Vasudha Jadhav, Jyotsna Paranjpe
Keywords
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