Effectiveness of Transverse Abdominis Plane Block as a Method of Regional Anaesthesia in Unilateral Inguinal Hernia Repair

ABSTRACT

The Transverses Abdominis Plane (TAP) block is a relatively new regional technique which is often used for sensory blockade of the lower abdominal wall mainly for post-operative pain relief. It causes sensory blockade mainly because of injection of local anaesthetic between the internal oblique and the transverse abdominis muscle. TAP block was performed using a blind landmark technique in the lumbar petit triangle. Nowadays USG guided TAP block is being performed in many centers. TAP block is known to improve postoperative pain, reduce the opioid demand, and also reduce the time to rescue analgesia in patients undergoing lower abdominal surgeries. In our study, we have used TAP block as a main anaesthetic technique in patients posted for unilateral inguinal hernia repair under elective conditions. TAP Block in this study was given with 0.5 % bupivacaine. Duration of anaesthesia / analgesia, effectiveness of block, period of block, cardiac stability and haemodynamic stability were studied. METHODSA prospective observational study was conducted on 30 randomly selected individuals posted for elective inguinal hernia repair who belonged to American Society of Anaesthesiologists classification 1 and 2; age group between 20 and 70 years; satisfying all inclusion and exclusion criteria. All the patients received 0.5 % bupivacaine for TAP block, dose not more than 2.5 mg / Kg body weight. RESULTSWe have found that TAP block gives good anaesthesia for patients posted for inguinal hernia repair with good haemodynamic stability. With inj. Bupivacaine 0.5 % having an onset of anaesthesia at about 7.45 + / - 2.32 minutes (p value < 0.001). The block was complete and effectively elevated nociceptive stimuli. The block lasted till the end of surgery in all cases, with no complications. CONCLUSIONSTAP block other than being the main anaesthetic technique for lower abdominal surgery, also provides good post-operative analgesia with minimal post-operative analgesic requirement with less haemodynamic variations.