A study of post-operative analgesia, ambulation and discharge in patient of inguinal hernia repair by tap block versus splash block
Journal Title: Medpulse International Journal of Anesthesiology - Year 2019, Vol 9, Issue 2
Abstract
Background: Innervation of the anterolateral abdominal wall arises from the anterior rami of spinal nerves T7 to L1. The anterior divisions of T7-T11 continue from the intercostal space to enter the abdominal wall between the internal oblique and transversus abdominis muscles untilthey reach the rectus abdominis, which they perforate and supply ending as anterior cutaneous branches supplying the skin of the frontof the abdomen. Aim: In this study, we evaluated the analgesic efficacy of TAP block andSplash block for the first 24 post-operative hours in patients undergoinginguinal hernia surgeries. Result: Patient’s characteristics were comparable among the two groups (table 1). Diclofenac consumption was almost reduced by approximately 40% in TAP block group compared to SPLASH block group which was statistically significant (p<.000). Time for first request for analgesia was statistically prolonged in TAP block group in comparison to Splash block group (table 2).Pain scores at rest and movement were 0 in PACU and at 2ndhour in both the groups. Statistically significant reduced pain scores were seen in TAP block group as compared to Splash block group from 4thto24th hour (Table 3, 4). Diclofenac requirement was almost negligible during first 4th hours postoperatively. During 4th to 12th hours, Diclofenac consumption was significantly low in TAP block group as compared to Splash block group. After 12 hours both groups are comparable.(table 5). Reduced post-operative nausea and vomiting was noticed in TAP block group as compared to Splash block group during 8th hour and 24th hour postoperatively. At other points of time, both the groups were comparable to each other and statistically significant difference was not found.(table 6,7). Antiemetic requirement was almost negligible in both the group during first 8th hours. Statistically significantly reduced requirement was observed during 8th – 24th hours in TAP block group as compared to Splash block group(p<.0001). (table 8). Overall 75% of the patients were satisfied with their analgesic regimen among TAP block group as compared to 50% among Splash block group.(table 9) Conclusion: Hence we conclude TAP block constitutes an effective analgesia after inguinal hernia surgeries as compared to Splash block. The ease with which it can be performed, an excellent safety profile, and outstanding clinical utility, will no doubt lead to increasing popularity and use of TAP block.
Authors and Affiliations
Avanish Kumar Saxena, Amrita Gupta, Pulkit Agarwal, Mahima Agarwal, Mahesh Singh
Keywords
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- EP ID EP521000
- DOI 10.26611/1015927
- Views 162
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