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Continuous Transversus Abdominis Plane Block for Primary Open Inguinal Hernia Repair: A Randomized, Double-Blind,
James M Flaherty1,2, David B Auyong2, Stanley C Yuan2
1University of Minnesota, Department of Anesthesiology, Minneapolis, Minnesota.
Pain Medicine (Malden, Mass.)
|November 1, 2019
Summary
Continuous transversus abdominis plane blocks offer minor pain relief after open inguinal hernia repair but do not significantly decrease opioid use. Further research is needed for enhanced pain management strategies.
Area of Science:
- Anesthesiology
- Surgical Pain Management
Background:
- Postoperative pain is a significant concern for patients undergoing open inguinal hernia repair.
- Multimodal analgesia is standard, but effective pain control remains a challenge.
Purpose of the Study:
- To evaluate the efficacy of continuous transversus abdominis plane (TAP) block in reducing opioid consumption after open inguinal hernia repair.
- To assess the impact of TAP block on pain scores and functional outcomes.
Main Methods:
- A randomized, double-blind, placebo-controlled trial was conducted with 90 adult patients.
- Patients received either a continuous TAP block or a sham block, alongside standard multimodal analgesia.
- Primary outcome was opioid consumption within 48 hours post-surgery; secondary outcomes included pain and activity scores.
Main Results:
- No significant difference in 48-hour opioid consumption was observed between the TAP block and sham groups (27.8 mg vs. 32 mg oxycodone equivalent).
- A statistically significant reduction in pain scores was noted at 24 hours in the TAP block group.
- No significant differences were found in other secondary outcomes, including activity assessment and adverse events.
Conclusions:
- Continuous TAP blocks provide modest improvements in pain but do not significantly reduce opioid consumption in patients undergoing open inguinal hernia repair.
- The addition of TAP blocks did not improve functional activity levels when used with multimodal analgesia.
