Abstract:
Background: The transversus abdominis plane (TAP) block proved to be effective in the pain management after inguinal hernia repair .
Objectives: To compare between 2approaches of TAP block as a postoperative analgesia after inguinal hernia repair in adults.
Methods: patients with elective unilateral uncomplicated inguinal hernia were randomly allocated into 3equal groups (19 patients in each group). Group 1: patients had TAP block through posterior approach .Group 2: patients had II-IH nerves block. Group 3: patients had general anesthesia only. All block technique would be done before general anesthesia. GA was standard for all patients.
Results: The control group show statistically significant higher level of VAS compared to the TAP block groups. As regard the posterior and II-IH groups, there was no statistically significant difference between them at PACU & at 2 hours then II-IH group show statistically significant higher level of VAS .Posterior group showed faster onset block with statistical significant difference than II-IH group. Time of first request of analgesia was statistically significantly longer in posterior group when compared to the II-IH & control groups. The total dose of nalbuphine consumption during first 24 hour postoperatively show less statistically significant consumption in posterior TAP block group when compared with ilio-inguinal and control groups.
Conclusion: Posterior transversus abdominis plane block is more effective than ilio-inginal /ilio-hypogastric nerves block in inguinal hernia repair as regard rapid onset of block, prolonged time of analgesia & lower requirement of opioid consumption postoperatively.
Keywords: transversus abdominis plane block, inguinal hernia, Postoperative analgesia.