Key result
Preemptive TAP block and local anesthetic infiltration are linked to similar postoperative tramadol use as IV dexketoprofen.
Why the study?
Although regional techniques are suggested for postoperative analgesia in inguinal hernia repairs, the ideal method remains controversial.
Does preemptive USG-guided TAP block or local anesthetic infiltration reduce postoperative pain and analgesic consumption compared to intravenous dexketoprofen in patients undergoing elective inguinal hernia surgery?
Observational (n=120)
No
Does preemptive USG-guided TAP block or local anesthetic infiltration reduce postoperative pain and analgesic consumption compared to intravenous dexketoprofen in patients undergoing elective inguinal hernia surgery?
Absolute Event Rate: 22.5% vs 20%
p-value: p=0.833
Preemptive TAP block provides superior early postoperative pain relief (lower VAS scores) compared to local infiltration or IV dexketoprofen, although total rescue analgesic consumption is similar.
Supports flexible preemptive analgesia choices in inguinal hernia repair; leaves open whether TAP block's early VAS benefit justifies preference pending RCTs.
Background Although regional techniques have been suggested more in order to provide postoperative analgesia in inguinal hernia repairs, the ideal method is still controversial. The aim of this study was to evaluate the effect of preemptive transversus abdominis plane (TAP) block, local anesthetic infiltration (LAI) and intravenous dexketoprofen (IVD) on postoperative pain in inguinal hernia repairs. Methods This prospective study included 120 patients with American Society of Anesthesiologists status 1-3 between 18-75 years of age who undergoing elective inguinal hernia surgery under spinal anesthesia. The patients were allocated into three groups: USG-guided TAP block (Group 1, n = 40), USG-guided LAI (Group 2, n = 40) and IVD (Group 3, n = 40) before surgical incision. The mean of tramadol consumption, number of patients in requiring rescue analgesics, duration of postoperative analgesia and complications were recorded for 24 hours postoperatively. VAS scores were evaluated at the 30 minute, 1, 2, 4, 8, 12, 16 and 24th hours. Results There was no significant difference between the postoperative mean tramadol consumption [Group 1: 22.5 mg; Group 2: 20 mg; Group 3: 27.5 (p 0.833)]. The number of patients requiring rescue analgesics was statistically similar (p 0.787). VAS scores at 30. min, 1, 2, 4, 8 and 12 hours were statistically lower in Group 1 than in the other groups (p 0.003, 007, 0013, 0049, 0015, 0021). VAS scores at 30. min and 2. h were lower in Group 1 than Group 2 (p 0.049, 0.037). İn addition, VAS scores at 30 min, 1, 2, 8 and 12 hours were lower in Group 1 than in Group 3 (p 0.003, 0.006, 0.021, 0.017, 0.016). VAS scores at all hours were statistically similar between Group 2 and Group 3. Conclusion This study demonsrated that preemptive transversus abdominis plane block, local anesthetic infiltration or iv dexketoprofen for postoperative analgesia in inguinal hernia repairs had similar effects on postoperative tramadol consumption and number of requiring rescue analgesic patients. However, TAP block provides lower VAS values and excellent analgesia in more patients in the first 24 hours postoperatively.
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Salık et al. (2020) conducted an observational in Inguinal hernia (n=120). Preemptive USG-guided transversus abdominis plane (TAP) block vs. USG-guided local anesthetic infiltration (LAI) and intravenous dexketoprofen (IVD) was evaluated on Postoperative mean tramadol consumption at 24 hours (p=0.833). Preemptive USG-guided TAP block, local anesthetic infiltration, and intravenous dexketoprofen resulted in similar postoperative tramadol consumption (22.5 mg vs 20 mg vs 27.5 mg, p=0.833) in patients undergoing inguinal hernia repair.
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