Comparative effectiveness of surgeon-performed transversus abdominis plane blocks and epidural catheters following open hernia repair with transversus abdominis release
This study evaluates the effectiveness of two postoperative analgesia modalities: epidural cat heter and surgeon-performed TAP-block following VHR performed with transversus abdominis release (TAR).MethodsA retrospective analysis was performed on data prospectively collected between 2012 and 2019. All patients undergoing open VHR with TAR performed by a single surgeon were identified. Parastomal hernia repairs and any patients receiving ultrasound-guided TAP blocks or paraspinal blocks were excluded. Primary outcome was length of stay (LOS) with secondary outcomes including pain scores, opioid requirements, and 30-day morbidity. Linear regression was used to model LOS.ResultsOne hundred thirty-five patients met inclusion criteria (63 epidural, 72 TAP-block). The majority (67.4%) of patients were modified ventral hernia working group grade 2. The only statistically significant difference in postoperative pain scores between the groups was on postoperative day 2 (TAP block 3.19 versus epidural 4.11,p = 0.0126). LOS was significantly shorter in the TAP block group (4.7 versus 6.2 days,p = 0.0023) as was time to regular diet (3.2 versus 4.7 days,p
Conclusions: Hernial sac stump fenestration after hernial sac transection in inguinal hernia repair surgery is a simple method that can effectively reduce post-operative ultrasound seromas.
ConclusionTAP block was effective in reducing postoperative pain scores for 4-6 hours, lowering total 24-h postoperative opioid and analgesic consumption and delaying the need for rescue analgesia after inguinal hernia repair under general anesthesia, compared to ilioinguinal/iliohypogastric nerves block. This technique can be a promising mode of postoperative analgesia when epidural catheter insertion is contraindicated.
AbstractBackgroundThe transversus abdominis plane (TAP) block is a known approach for blocking the abdominal wall neural afferents via the bilateral lumbar triangles of Petit. Different adjuvants have been used to intensify the quality and the duration of local anesthetics.Aim of the WorkThe aim of this study is to detect the efficacy and safety of magnesium sulphate as an adjuvant to the analgesia offered by local anesthetic in ultrasound guided TAP block in patients undergoing surgical repair of moderate sized umilical hernia under general anathesia. As regard postoperative pain and opioid consumption using Visual Analog...
Agri. 2021 Jul;33(3):194-196. doi: 10.14744/agri.2019.41033.ABSTRACTAnkylosing spondylitis is a challenging disease for anesthesiologist due its airway and axial skeleton involvement. A 55 years old male patient suffering from severe ankylosing spondylitis, admitted to Anesthesiology Clinic. He was planned to receive a midline open ventral hernia repair. We decided to perform bilateral ultrasound-guided erector spinae plane (ESP) block at the level of T8 with 0.4 mcg kg-1 hour-1 dexmedetomidine sedation for complete anesthesia of the surgery. We performed ESP block with 25 mL of 0.25% bupivacaine and repeated the same proc...