Online ISSN: 2515-8260

An Observational Study to Evaluate USG Guided Transversus Abdominis Plane Block and Wound Site Infiltration Using 0.25% Bupivacaine for Post Operative Pain Relief in Patients Undergoing Open Inguinal Hernia Surgeries

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Dr. Nasrin Banu1 , Dr. Ruchi Tandon2 , Dr. Shifa3 , Dr. Vandana Pandey4 , Hiteshi Bais5

Abstract

Background: Postoperative analgesia remains a cornerstone in management of patients undergoing inguinal hernia repair. This study evaluates the analgesic efficacy of traditional wound site infiltration and recent ultrasound guided TAP block using VAS score. Sixty patients were divided into two Groups. Patients in Group 1 were given ultrasound guided TAP block with 20ml of 0.25% bupivacaine and patients in Group 2 received wound site infiltration with 20 ml 0.25% bupivacaine as per the discretion of anaesthesiologist. Postoperative parameters like VAS score, time to first rescue analgesia, total analgesic consumption, adverse events and hemodynamic parameters were assessed. Methods: Sixty patients who met the inclusion criteria posted for elective unilateral inguinal hernia surgeries were divided into two Groups Group 1 received ultrasound guided TAP block with 20ml of 0.25% bupivacaine and Group 2 received wound site infiltration with 20 ml 0.25% bupivacaine. Postoperatively patients were shifted to post-operative ward and monitored for post-operative pain using VAS score at various postoperative intervals; 2, 4, 6, 12, 18, 24 hours and secondary parameters such as duration of analgesia, time to first rescue analgesia, total analgesic consumption and adverse events were also recorded. Results: VAS scores recorded at various post-operative intervals, total analgesic consumption were significantly lower in USG-TAP block Group compared to WSI Group which was significant statistically. The mean time requirement for rescue analgesia was shorter in the WSI Group (3.67h) than the USG-TAP block (6.43h) and was statistically significant. Conclusion: Being simpler and accurate ultrasound guided TAP block can be utilised for providing sound analgesia for inguinal hernia surgeries postoperatively. As a multimodal analgesia regimen, TAP block has proven to reduce the total analgesic consumption and additional analgesics requirement, with additional advantage of mitigating complication by ultrasound guidance.

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