Interfascial Blockages of the Abdominal Wall With the Eras Protocol in Videolaparoscopic Surgery for Inginal Hernia

Actuality Up to 75% of postoperative patients experience pain, while less than half of these patients can note the adequacy of postoperative pain therapy. Inadequate control of perioperative pain leads to medical, economic, and social adverse events. A modern approach to postoperative analgesia is a multidisciplinary ERAS strategy, a component of which is multimodal analgesia, especially with the use of regional nerve blocks. Goal of the Work Assessment of the effectiveness of recovery in the early postoperative period of patients who underwent video laparoscopic interventions for inguinal hernias, depending on the use of interfascial blockades of the abdominal wall as part of anesthesiological support of multimodal analgesia. Materials and Methods A prospective comparative study of the effectiveness of postoperative recovery of 89 patients after videolaparoscopic interventions for inguinal hernias was conducted. All of them underwent alloplasty according to the transabdominal preperitoneal repair (TAPP) technique in the period 2020–2023. 75.3% were male. Patients had a mean age of 52.3 years and a mean BMI of 29.2. The patients were divided into 2 groups: in the main group – 46 people (52%) as part of anesthesiological intraoperative support, transversus muscle blocks (TAP-blocks), quadrato-lumbar blocks (QL-blocks) and rectus abdominal muscles sheath blocks were additionally performed; in the comparison group – 42 people (48%) additional interfascial blocks were not performed. The following were evaluated: intraoperative Fentanyl consumption, the need for additional administration of analgesics in the postoperative period, assessment of postoperative pain according to the visual analog scale (VAS), recovery time of motor activity within the ward, the time of discharge from the hospital. Research results In the patients of the main group, compared to the comparison group, the following features were noted: under the condition of using interfascial blocks of the abdominal wall intraoperative fentanyl consumption decreased by 2.4 times, the frequency of additional administration of analgesics in the postoperative period was 1.9 times lower, postoperative pain assessment according to VAS was 1.6 times smaller, recovery of motor activity within the ward took place earlier by an average of 5.5 hours, the time of discharge from the hospital decreased by 1.8 times, the average bed-day was 1.2 days. Conclusions Interfascial blocks of the abdominal wall are an important component of the ERAS protocol, which have positive medical, social and economic effects.