Comparing laparoscopic transversus abdominis plane block and port-site infiltration in laparoscopic ventral hernia repair: A randomised controlled trial

This is the authors' abstract. We don't add key points for this paper.

INTRODUCTION: Adequate analgesia is of utmost importance for apposite in patients undergoing laparoscopic ventral hernia repair (LVHR) for smooth recovery. TAP block and port-site infiltration (PSI) are two most commonly employed methods for pain relief. Therefore, this study was done to compare laparoscopic-guided TAP block versus PSI for post-operative analgesia, hospital stay and rescue dose of analgesic in LVHR. PATIENTS AND METHODS: This single-blinded randomised controlled trial was done in a tertiary hospital of Delhi from 1 April 2023, to 1 August 2024. A total of 60 patients were enrolled. Randomisation was done using computer-generated random number table, and allotment was done using sequentially numbered opaque sealed envelopes. All patients >18 years of age with anterior abdominal wall hernia undergoing LVHR were included in the study. Patients with a history of opioid usage, patients with alcohol abuse within the past 6 months, patients with hernia size >6 cm were excluded from the study. Two groups included: test group (Group A) - laparoscopic-assisted TAP block (LTAP) and control Group (Group B) - port-site local anaesthesia infiltration (PSLAI). RESULTS: In LVHR, the use of TAP blocks showed superior pain management compared to PSLAI (significantly lower VAS scores at 6, 12 and 24-h post-surgery in the LTAP group [P = 0.0031, 0.0037 and 0.00012, respectively]). LTAP was associated with a shorter hospital stay (P = 0.016) and less need for rescue analgesia (P = 0.031). CONCLUSION: Laparoscopic transverse abdominis plane block is superior to port-site local anaesthesia infiltration in providing effective post-operative analgesia.