Pilot Study of Ambulatory Inguinal Hernia Repair under Ultrasound-guided Transversus Abdominis Plane Block Anesthesia Plus Conscious Sedation.
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Date
2014-06-11
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Abstract
Aim: Transversus abdominis plane (TAP) block is mainly used as part of multimodal
postoperative analgesia regimens in a wide variety of abdominal operations. Our purpose
was to evaluate feasibility and safety of TAP block as anesthesia method for inguinal
hernia repair.
Methodology: Twenty patients scheduled to undergo ambulatory inguinal hernia repair
were selected and consented to ultrasound-guided TAP block anesthesia plus conscious
sedation. Twenty to 25 ml of ropivacaine 0.5% were administered into the TAP and
sensory blockade of T11-L1 dermatomes was examined 30 minutes later. Data on intraoperative tolerance, postoperative pain levels, rescue analgesia requirements,
ambulation and complications were recorded.
Results: Nineteen blocks (95%) were successful. One patient (5%) required conversion
to general anesthesia. One patient (5%) needed further local anesthetic infiltration before
mesh fixation. Postoperative pain levels were excellent, with only one patient (5%)
requiring rescue analgesia at home. No complications were observed and all patients
were discharged on the evening of surgery.
Conclusion: Inguinal hernias can be safely repaired under ultrasound-guided TAP block
anesthesia. Preliminary data are encouraging, in terms of intraoperative anesthesia
adequacy, postoperative pain levels and rescue analgesia requirements. The role of TAP
block as anesthetic modality for abdominal wall operations should be further investigated.
Description
Keywords
Inguinal hernia, transversus abdominis plane, TAP block, ambulatory surgery, regional anesthesia
Citation
Manatakis Dimitrios K, Stamos Nikolaos, Dontas loannis D, Agalianos Christos, Gkiaourakis Michael, Karvelis Michail Athanasios, Kyriazanos loannis D, Davides Demetrios. Pilot Study of Ambulatory Inguinal Hernia Repair under Ultrasound-guided Transversus Abdominis Plane Block Anesthesia Plus Conscious Sedation. British Journal of Medicine and Medical Research. 2014 June; 4(17): 3269-3275.