COMPARISON OF ULTRASOUND-GUIDED TRANSVERSUS ABDOMINIS PLANE BLOCK AND LOCAL ANESTHETIC WOUND INFILTRATION FOR POST-OPERATIVE PAIN CONTROL IN INGUINAL HERNIA REPAIR
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Keywords
Inguinal hernia; Block; Local anesthetic.
Abstract
Inguinal hernia is one of the most common surgical conditions worldwide, frequently managed as a day-care procedure due to advancements in surgical and anesthetic techniques. Postoperative pain remains a major concern after inguinal hernia repair, with reports suggesting that up to 43% of patients may experience persistent discomfort. Effective analgesia is essential for early ambulation, reduced hospital stay, and improved patient satisfaction. Two commonly used methods for postoperative pain control include ultrasound-guided Transversus Abdominis Plane (TAP) block and local anesthetic infiltration at the surgical incision site. This study aimed to compare mean postoperative pain scores between these two techniques. A total of 60 male patients aged 18–80 years, classified as ASA I–II, undergoing elective inguinal hernia surgery were randomly assigned to two groups. Arm 1 received local anesthetic wound infiltration, while Arm 2 received an ultrasound-guided TAP block. Postoperative monitoring was conducted for 6 hours by a blinded anesthesia nurse, and pain scores and analgesic requirements were recorded. Of the participants, 66.7% were ASA I, and the median surgical duration was 70 minutes. Overall, 55% required additional analgesics, with a median analgesia duration of 3.2 hours. The median VAS pain score was 6. BMI distribution showed 60% with normal BMI, 20% obese, and 11.7% overweight. A significant difference was noted in surgical duration between groups (p = 0.03), but no statistically significant difference in pain scores was found after adjusting for confounders. In conclusion, TAP block and local wound infiltration provided comparable postoperative analgesia, with a trend toward fewer analgesic requests in the local infiltration group.
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Bahram Khan
Senior Registrar, SIUT karachi, Pakistan, doctor.bahram.khan@gmail.com
Mobashir Ul Haque
Senior Registrar, Sindh Infectious Diseases Hospital, Pakistan, mobashirulhaque.23@gmail.com
Hira Ali
Senior Registrar, Sindh Infectious Diseases Hospital, Pakistan, dr.hiraali@hotmail.com
Mubarak Shah
Consultant Anesthesia, The Kidney Center, Karachi, drmsmaseed@gmail.com
Farjad Sultan
Chairperson Anesthesia ICU and Pain services, Civil Hospital Karachi. Pakistan, farjad.sultan@duhs.edu.pk
