Laparoscopic-assisted transversus abdominis plane block as an effective analgesic in total extraperitoneal inguinal hernia repair: a double-blind, randomized controlled trial

AbstractPurposeLaparoscopic inguinal hernia repair has facilitated early mobilization. Management of post-operative pain is paramount in these day case procedures. The aim of this study was to compare laparoscopic-assisted transversus abdominis plane (TAP) block with periportal local anaesthetic infiltration in managing post-operative pain.MethodsA double-blind, randomized controlled trial was conducted with patients undergoing elective laparoscopic inguinal hernia repair (January 2016 –October 2017). The intervention group received laparoscopic-assisted TAP block with 30 ml 0.25% Bupivacaine. The control group received 15ml of 0.5% Bupivacaine at the periportal sites. Primary outcome measure was assessment of post-operative pain scores using numerical rating on visual analogue scale (VAS) at rest and on coughing at 3 h. Efficacy of TAP block was assessed as reduction in mean pain scores in the order of 2 points using the VAS.Results60 (57 males and 3 females) were enrolled; 30 patients were randomized to each group. Patient demographics, anaesthetic and surgical times were similar in both groups. Mean pain scores were significantly reduced in the intervention group at 3 (3.1 vs 1.1p 
Source: Hernia - Category: Sports Medicine Source Type: research

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Authors: Kendall MC, Alves LJC, Suh EI, McCormick ZL, De Oliveira GS Abstract Regional anesthesia is becoming increasingly popular among anesthesiologists in the management of postoperative analgesia following pediatric surgery. The main objective of this review was to systematically evaluate the last 5 years of randomized controlled trials on the role of regional anesthesia techniques in alleviating postoperative pain associated with various pediatric surgical procedures. Forty studies on 2,408 pediatric patients were evaluated. The majority of the articles published from 2013 to 2017 reported that the use of regi...
Source: Local and Regional Anesthesia - Category: Anesthesiology Tags: Local Reg Anesth Source Type: research
ConclusionsThe HerniaSurge Group has developed these extensive and inclusive guidelines for the management of adult groin hernia patients. It is hoped that they will lead to better outcomes for groin hernia patients wherever they live. More knowledge, better training, national audit and specialization in groin hernia management will standardize care for these patients, lead to more effective and efficient healthcare and provide direction for future research.
Source: Hernia - Category: Sports Medicine Source Type: research
We report a 69-year-old woman with bilateral diaphragmatic paralysis who underwent a laparoscopic hernia repair and an open laparotomy for reversal of a Hartmann procedure under general anesthesia. Postoperative analgesia was provided by intravenous opioid and epidural local anesthetic and opioid, respectively. The patient’s trachea was successfully extubated at the end of both surgical procedures. Epidural analgesia was associated with better pain control and shorter intensive care unit stay.
Source: A&A Case Reports - Category: Anesthesiology Tags: Case Reports: Case Report Source Type: research
CONCLUSION: Pain management was inadequate in most of the groups studied, particularly after appendicectomy or umbilical hernia repair, with most children experiencing at least moderate pain on the day of and day after surgery. There was a need for a standardized management, with increased dual analgesia prescribing, to ensure that children receive adequate postoperative analgesia in hospital and at home. PMID: 29030932 [PubMed - in process]
Source: Paediatric Anaesthesia - Category: Anesthesiology Authors: Tags: Paediatr Anaesth Source Type: research
ConclusionPain management was inadequate in most of the groups studied, particularly after appendicectomy or umbilical hernia repair, with most children experiencing at least moderate pain on the day of and day after surgery. There was a need for a standardized management, with increased dual analgesia prescribing, to ensure that children receive adequate postoperative analgesia in hospital and at home.
Source: Pediatric Anesthesia - Category: Anesthesiology Authors: Tags: RESEARCH REPORT Source Type: research
Despite its minimally invasive approach, laparoscopic surgery can cause considerable pain. Regional analgesic techniques such as the rectus sheath block (RSB) offer improved pain management following elective umbilical hernia repair in the pediatric population. This effect has not been examined in laparoscopic single-incision surgery in children. We sought to compare the efficacy of bilateral ultrasound-guided RSB versus local anesthetic infiltration (LAI) in providing postoperative pain relief in pediatric single-incision transumbilical laparoscopic assisted appendectomy (TULA) with same-day discharge.
Source: Journal of Pediatric Surgery - Category: Surgery Authors: Source Type: research
Abstract Background By common perspective, it is generally considered that laparoscopic inguinal hernia repairs (LIHR) are comparable to conventional operative methods, as an equivalent treatment methodology in the management of inguinal hernias. The results of current studies, however, favour an LIHR in comparison to an open mesh repair (OMR) in selected patient populations. The advantages of LIHR lie in the clearer view of the spermatic cord contents it offers, and, as a result, it is a safer method in the preservation of testicular function, with fewer incidences of acute and chronic pain, ...
Source: European Surgery - Category: Surgery Source Type: research
To the Editor Postoperative pain after laparoscopic surgery is one of the major concerns of patients. Improper pain management could be associated with varied respiratory, cardiovascular, gastrointestinal, and psychological complications. Thromboembolic events could occur following reduced mobility due to postoperative pain. Furthermore, activation of stress responses can lead to water and sodium retention and an increased metabolic rate. Gough et al suggest that after mesh placement (ie, after laparoscopic ventral hernia repair), a long-acting local anesthetic (bupivacaine hydrochloride, 0.50%) injected between the mesh a...
Source: JAMA Surgery - Category: Sports Medicine Source Type: research
Abstract The duration of hospital stay following surgical procedures has undergone a significant reduction in the last 10 years. With advances in anaesthesia, immediate postoperative care and surgical techniques, increasingly more procedures, such as hernia repair, laparoscopic cholecystectomy, breast surgery and other minor operations, are now performed on an outpatient surgery basis. Outpatient surgery is defined as same-day discharge from a hospital-based surgical unit, not requiring an overnight hospital or postoperative recovery unit stay. The rationale for performing same-day surgery relies on a combination...
Source: Hellenic Journal of Surgery - Category: Surgery Source Type: research
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