SVU - International Journal of Medical Sciences (Jan 2019)
Evaluation of three different regional anesthetic techniques in postoperative pain control after inguinal hernia repair operations in adults patients
Abstract
Background: Various analgesic modalities have been used for postoperative analgesia in patients undergoing inguinal hernia surgery.In this randomized clinical trial, we have compared the analgesic efficacy of transverses abdominis plane (TAP) block with that of ilioinguinal/ iliohypogastric (II-IH) nerve block and quadrates lamborum(QL) block in patients undergoing unilateral open inguinal hernia repair. Objectives: comparison of the efficacy of either of the three types of regional anesthetic blocks , the ultrasound –guided TAP block , ultrasound-guided Quadratus Lamborum block and ultrasound- guided ilioinguinal and iliohypogastric nerve block in quality and duration of postoperative pain control. Patients and methods:This is a cross-sectional, hospital based study carried out on 90 cases undergoing inguinal hernia repair under general anesthesia using either of the three types of block in each group; the ultrasound–guided TAP block , ultrasound- guided ilioinguinal and iliohypogastric nerve block and ultrasound-guided Quadratus Lamborum block nerve All cases enrolled fromgeneralsurgerydepartment and seen at the pre operative holding area before going to the operative theatre of Qena university hospital between August 2018 to August 2019 . Result(s):VAS were lower in the IINB group and QLB group compared to the TAP block group both at rest and during cough. The difference in VS score was statistically significant various times postoperative. Time to first analgesic request was delayed in IIIH nerve block Group(7.3±1.3 ) hours than TAP block group (5.9±1.3)hours (P value .008)and time to first analgesic request was delayed in QL block Group (10.3±3.9) hours than TAP block group (5.9±1.3)hours (P value 0.001) .15 patients (50%) in TAP block group,10 patient (33.3%) in IINB group and 4 patients (13.3%)required morphine 24 hours postoperative . Conclusion:This study demonstrated that compared to TAP block II-IH nerve block and QL block provides better pain control after open repair of inguinal hernia when all blocks were administered under US guidance.
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