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Updated: Mar 29, 2026

Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
Published on: January 31, 2025
Comparative Effectiveness of Two Ultrasound-Guided Regional Block Techniques for Surgical Anesthesia in Open
Lauren Steffel1, T Edward Kim1, Steven K Howard1
1Department of Anesthesiology, Perioperative and Pain Medicine (L.S., T.E.K., S.K.H., A.K., E.R.M.) and Division of General Surgery (D.P.L.), Stanford University School of Medicine, Stanford, California USA; and Anesthesiology and Perioperative Care Service (T.E.K., S.K.H., R.K., E.R.M.) and Surgical Service (D.P.L.), VA Palo Alto Health Care System, Palo Alto, California USA.
Abstract:
Transversus abdominis plane (TAP) and ilioinguinal/iliohypogastric (II/IH) nerve blocks have been described as analgesic adjuncts for inguinal hernia repair, but the efficacy of these techniques in providing intraoperative anesthesia, either individually or together, is not known. We designed this retrospective cohort study to test the hypothesis that combining TAP and II/IH nerve blocks ("double TAP" technique) results in greater accordance between the preoperative anesthetic plan and actual anesthetic technique provided when compared to TAP alone. Based on this study, double TAP may be preferred for patients undergoing open inguinal hernia repair who wish to avoid general anesthesia.
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