ROLE OF TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCK IN ANALGESIA AND EARLY REHABILITATION IN PATIENTS WITH INGUINAL HERNIAS
EAES Academy. Ushnevych Z. 07/05/22; 363086; P131
Zhanna Ushnevych
Contributions
Contributions
Abstract
Aim. To evaluate the efficiency and role of TAP block in analgesia and early rehabilitation in patients with inguinal hernias.
Methods. The study included 56 patients who underwent laparoscopic transabdominal preperitoneal hernioplasty for inguinal hernias during 2020 in the surgical department of Lviv Regional Clinical Hospital. The mean age of patients was 63.2 ± 12.2 years. We applied the principles of ERAS protocols in every case. All patients underwent general inhalation anesthesia with sevoflurane. Intraoperatively, fentanyl was administered at a dose of 100 μg before tracheal intubation, then, if necessary. Patients were divided into 2 groups: group I (n = 32) we used intravenous multimodal non-opioid analgesia after surgery; in group II (n = 24) after tracheal intubation, a TAP block was performed under ultrasound control with bupivacaine and lidocaine combination. After surgery, if necessary, intravenous dexketoprofen was administered. There were no significant statistical difference in both groups in age, body weight and hernia size. Anesthetic risk in patients of both groups was assessed as ASA II-III.
Results:
Intraoperatively, the need for fentanyl in group I was 280 ± 54 mcg, in group II 120 ± 40 mcg. The average intensity of pain for visual analog scale for the first day after surgery was 2.5 ± 0.5 points in group I, 1.2 ± 0.4 points in group II. Only 3 patients (12.5%) from group II required additional single administration of dexketoprofen in the first day after surgery. There was no need for opioids in the postoperative period in either patient in either group. In group I, postoperative nausea occurred in 4 patients (12.5%) and vomiting in one patient (3.1%). In group II, no patients had episodes of postoperative nausea and vomiting. Group I patients were able to verticalize and walk an average of 12 hours after surgery, this interval in group II was – 6 hours. The first full meal in group I took place on average 7 hours after surgery, and in group II - 4 hours after surgery.
Conclusions. TAP block significantly improves the quality of analgesia, reduces the intraoperative need for opioids and accelerates the rehabilitation of patients.
Methods. The study included 56 patients who underwent laparoscopic transabdominal preperitoneal hernioplasty for inguinal hernias during 2020 in the surgical department of Lviv Regional Clinical Hospital. The mean age of patients was 63.2 ± 12.2 years. We applied the principles of ERAS protocols in every case. All patients underwent general inhalation anesthesia with sevoflurane. Intraoperatively, fentanyl was administered at a dose of 100 μg before tracheal intubation, then, if necessary. Patients were divided into 2 groups: group I (n = 32) we used intravenous multimodal non-opioid analgesia after surgery; in group II (n = 24) after tracheal intubation, a TAP block was performed under ultrasound control with bupivacaine and lidocaine combination. After surgery, if necessary, intravenous dexketoprofen was administered. There were no significant statistical difference in both groups in age, body weight and hernia size. Anesthetic risk in patients of both groups was assessed as ASA II-III.
Results:
Intraoperatively, the need for fentanyl in group I was 280 ± 54 mcg, in group II 120 ± 40 mcg. The average intensity of pain for visual analog scale for the first day after surgery was 2.5 ± 0.5 points in group I, 1.2 ± 0.4 points in group II. Only 3 patients (12.5%) from group II required additional single administration of dexketoprofen in the first day after surgery. There was no need for opioids in the postoperative period in either patient in either group. In group I, postoperative nausea occurred in 4 patients (12.5%) and vomiting in one patient (3.1%). In group II, no patients had episodes of postoperative nausea and vomiting. Group I patients were able to verticalize and walk an average of 12 hours after surgery, this interval in group II was – 6 hours. The first full meal in group I took place on average 7 hours after surgery, and in group II - 4 hours after surgery.
Conclusions. TAP block significantly improves the quality of analgesia, reduces the intraoperative need for opioids and accelerates the rehabilitation of patients.
Aim. To evaluate the efficiency and role of TAP block in analgesia and early rehabilitation in patients with inguinal hernias.
Methods. The study included 56 patients who underwent laparoscopic transabdominal preperitoneal hernioplasty for inguinal hernias during 2020 in the surgical department of Lviv Regional Clinical Hospital. The mean age of patients was 63.2 ± 12.2 years. We applied the principles of ERAS protocols in every case. All patients underwent general inhalation anesthesia with sevoflurane. Intraoperatively, fentanyl was administered at a dose of 100 μg before tracheal intubation, then, if necessary. Patients were divided into 2 groups: group I (n = 32) we used intravenous multimodal non-opioid analgesia after surgery; in group II (n = 24) after tracheal intubation, a TAP block was performed under ultrasound control with bupivacaine and lidocaine combination. After surgery, if necessary, intravenous dexketoprofen was administered. There were no significant statistical difference in both groups in age, body weight and hernia size. Anesthetic risk in patients of both groups was assessed as ASA II-III.
Results:
Intraoperatively, the need for fentanyl in group I was 280 ± 54 mcg, in group II 120 ± 40 mcg. The average intensity of pain for visual analog scale for the first day after surgery was 2.5 ± 0.5 points in group I, 1.2 ± 0.4 points in group II. Only 3 patients (12.5%) from group II required additional single administration of dexketoprofen in the first day after surgery. There was no need for opioids in the postoperative period in either patient in either group. In group I, postoperative nausea occurred in 4 patients (12.5%) and vomiting in one patient (3.1%). In group II, no patients had episodes of postoperative nausea and vomiting. Group I patients were able to verticalize and walk an average of 12 hours after surgery, this interval in group II was – 6 hours. The first full meal in group I took place on average 7 hours after surgery, and in group II - 4 hours after surgery.
Conclusions. TAP block significantly improves the quality of analgesia, reduces the intraoperative need for opioids and accelerates the rehabilitation of patients.
Methods. The study included 56 patients who underwent laparoscopic transabdominal preperitoneal hernioplasty for inguinal hernias during 2020 in the surgical department of Lviv Regional Clinical Hospital. The mean age of patients was 63.2 ± 12.2 years. We applied the principles of ERAS protocols in every case. All patients underwent general inhalation anesthesia with sevoflurane. Intraoperatively, fentanyl was administered at a dose of 100 μg before tracheal intubation, then, if necessary. Patients were divided into 2 groups: group I (n = 32) we used intravenous multimodal non-opioid analgesia after surgery; in group II (n = 24) after tracheal intubation, a TAP block was performed under ultrasound control with bupivacaine and lidocaine combination. After surgery, if necessary, intravenous dexketoprofen was administered. There were no significant statistical difference in both groups in age, body weight and hernia size. Anesthetic risk in patients of both groups was assessed as ASA II-III.
Results:
Intraoperatively, the need for fentanyl in group I was 280 ± 54 mcg, in group II 120 ± 40 mcg. The average intensity of pain for visual analog scale for the first day after surgery was 2.5 ± 0.5 points in group I, 1.2 ± 0.4 points in group II. Only 3 patients (12.5%) from group II required additional single administration of dexketoprofen in the first day after surgery. There was no need for opioids in the postoperative period in either patient in either group. In group I, postoperative nausea occurred in 4 patients (12.5%) and vomiting in one patient (3.1%). In group II, no patients had episodes of postoperative nausea and vomiting. Group I patients were able to verticalize and walk an average of 12 hours after surgery, this interval in group II was – 6 hours. The first full meal in group I took place on average 7 hours after surgery, and in group II - 4 hours after surgery.
Conclusions. TAP block significantly improves the quality of analgesia, reduces the intraoperative need for opioids and accelerates the rehabilitation of patients.
{{ help_message }}
{{filter}}