Their Duration of Anesthesia/Analgesia in Transversus Abdominis Plane Block for Unilateral Inguinal

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Their Duration of Anesthesia/Analgesia in Transversus Abdominis Plane Block for Unilateral Inguinal

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Background: The transversus abdominus plane block is a regional anesthesia technique first described in 2001. It is useful in procedures requiring nerve block in the anterior abdominal wall region from T6-L1. It was first used as a blind landmark technique. But more recently it has been performed under ultrasound guidance. TAP blocks are important because they can be used as an alternative analgesic solution in surgery. The purpose of our study was to evaluate effectiveness of TAP block to provide effective postoperative analgesia in patients undergoing inguinal hernia repair surgery. Materials and Methods: Our study was conducted in our institution under ultrasound guidance. Total 40 patients undergoing unilateral inguinal hernioplasty surgery under spinal anesthesia were included in the study. Patients were divided into 2 groups of 20 each. Group B - Patients receiving USG-TAP block at the end of surgery with 20 ml Inj. Bupivacaine 0.50% - 20 patients. Group R - Patients receiving USGTAP block at the end of surgery with 20 ml Inj. Ropivacaine 0.75% - 20 patients. Patient monitored every two hours upto 24 hours postoperatively for pulse rate, BP, pain by VAS score and complications if any. Pain was assessed by visual analog score from 0 to 10. Recession of motor block noted by movement of ankle and knee joint. Results: The mean pain score on VAS in Group B and Group R was 4.75 and 4.89 respectively, 24 hours after surgery. The difference in the two groups was statistically insignificant (p - value > 0.05). VAS score was the same in both the groups at all the time in first 24 hours. Conclusion: About 15 ml of 0.5 % bupivacaine or 15 ml of 0.75 % ropivacaine for transverse abdominis plane block produces satisfactory and comparable sensory block, related to duration, analgesia and VAS score. The hemodynamics were stable in both the groups. The lower CNS and cardio toxicity of ropivacaine may help in reducing the risk to the patients. There was no much clinical difference in duration, dose of analgesia and VAS score among both the groups, when injected in equal volume for TAP block under ultrasound guidance. Ropivacaine has a potentially improved safety profile when compared with Bupivacaine.

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