Comparison of efficacy of transversus abdominis plane block and iliohypogastric/ilioinguinal nerve block for postoperative pain management in patients undergoing inguinal herniorrhaphy with spinal anesthesia: a prospective randomized controlled open-label study

AbstractPurposesThe purpose of this study was to compare the effects of lateral abdominal transversus abdominis plane block (TAP block) and iliohypogastric/ilioinguinal nerve block (IHINB) under ultrasound guidance for postoperative pain management of inguinal hernia repair. Secondary purposes were to compare the complication rates of the two techniques and to examine the effects of TAP block and IHINB on chronic postoperative pain.MethodsThis was a prospective randomized controlled open-label study. After approval of the Research Ethics Board, a total of 90 patients were allocated to three groups of 30 by simple randomized sampling as determined with a priori power analysis. Peripheral nerve blocks (TAP block or IHINB) were administered to patients following subarachnoid block according to their allocated group. Patient pain scores, additional analgesic requirements and complication rates were recorded periodically and compared.ResultsPain scores were significantly lower in the study groups (p 
Source: Journal of Anesthesia - Category: Anesthesiology Source Type: research

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Conclusion: It is important to consider mesh graft migration to viscus as a cause of persistent abdominal pain and bleeding per rectum irrespective of the time of presentation post hernia repair. PMID: 31788028 [PubMed]
Source: Patient Safety in Surgery - Category: Surgery Authors: Tags: Patient Saf Surg Source Type: research
ConclusionA detailed understanding of inguinal anatomy is an indispensable basic requirement for all surgeons to perform inguinal ultrasonography as well as open inguinal hernia repair, avoiding complications, especially postoperative inguinodynia.
Source: Hernia - Category: Sports Medicine Source Type: research
A significant number of patients who undergo a standard inguinal hernia repair or a Pfannenstiel incision develop chronic (> 3 months) post-surgical inguinal pain (PSIP) due to nerve entrapment. If medication ...
Source: BMC Surgery - Category: Surgery Authors: Tags: Study protocol Source Type: research
I came across this public-accesss story, and wanted to share the perspective: Pauline Bartolone, Kaiser Health News Even as opioids flood American communities and fuel widespread addiction, hospitals are facing a dangerous shortage of the powerful painkillers needed by patients in acute pain, according to doctors, pharmacists and a coalition of health groups. The shortage, though more significant in some places than others, has left many hospitals and surgical centers scrambling to find enough injectable morphine, Dilaudid and fentanyl — drugs given to patients undergoing surgery, fighting cancer or suffering traumat...
Source: Suboxone Talk Zone - Category: Addiction Authors: Tags: Acute Pain Anesthesia Public policy surgery Chronic pain opioid addiction Source Type: blogs
Walter Sebastian Nardi, Guido Luis Busnelli, Ariel Tchercansky, Daniel E Pirchi, Pablo José MedinaJournal of Minimal Access Surgery 2018 14(2):161-163A 63-year-old man with a history of a conventional cholecystectomy was referred to our department for an incisional subcostal hernia and chronic back pain. Physical examination also showed an umbilical hernia and diastasis recti measuring 6 cm that was confirmed with a computed tomography scan. Subcutaneous video-endoscopic repair was done repairing all defects simultaneously.
Source: Journal of Minimal Access Surgery - Category: Surgery Authors: Source Type: research
ConclusionsThe Rives technique requires a sound knowledge of inguinal preperitoneal space anatomy, but it is an excellent technique for the larger and difficult primary inguinal hernias, giving a low rate of recurrences and chronic pain.
Source: World Journal of Surgery - Category: Surgery Source Type: research
This study shows that new chronic opioid use after surgery may be one of the most common complications after surgery,” said lead study author Dr. Chad Brummett of the University of Michigan in Ann Arbor. “Given that the rates of new chronic use did not differ between major and minor surgery, this suggests that patients continue to use their opioids for reasons other than the pain from the surgery,” Brummett added by email. Addressing patients’ acute pain during their recovery from surgery may be a way to prevent them from becoming a statistic in the opioid epidemic, he suggested. About 50 million pe...
Source: Healthy Living - The Huffington Post - Category: Consumer Health News Source Type: news
I recently gave a lecture to medical students about opioid dependence and medication assisted treatment using buprenorphine, methadone, or naltrexone. I was happy to see their interest in the topic, in contrast to the utter lack of interest in learning about buprenorphine shown by practicing physicians. In case someone from the latter group comes across this page, I’ll list a few things to do or to avoid when caring for someone on buprenorphine (e.g. Suboxone). 1. Buprenorphine does NOT treat acute pain, so don’t assume that it will. Patients are fully tolerant to the mu-opioid effects of buprenorphine, so they...
Source: Suboxone Talk Zone - Category: Addiction Authors: Tags: Acute Pain Addiction Buprenorphine Chronic pain Suboxone surgery buprenorphine stigma Source Type: blogs
Chronic inguinodynia (groin pain) is a common complication following open inguinal hernia repair or a Pfannenstiel incision but may also be experienced after other types of (groin) surgery. If conservative tre...
Source: Trials - Category: Journals (General) Authors: Source Type: research
Discussion Varicoceles are caused by high venous back pressure which causes a tortuous dilatation of the testicular veins (pampiniform plexus) of the spermatic cord. They occur more on the left than right because the left renal vein has a higher pressure than the inferior vena cava which drain the left and right gonadal veins respectively. Varicoceles are not very common in young children (3% in
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
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