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A randomized controlled trial on the effectiveness of laparoscopic-guided transversus abdominis plane block in patients undergoing laparoscopic IPOM plus

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Abstract

Introduction

Ventral hernia repairs, particularly laparoscopic ventral hernia repair (LVHR), have become common procedures among general surgeons worldwide. Despite the benefits of LVHR, acute postoperative pain remains a significant concern. Transversus abdominis plane (TAP) blocks have been employed to alleviate postoperative pain in various laparoscopic procedures. This study aimed to assess the effectiveness of laparoscopic-guided TAP block in laparoscopic IPOM plus and its impact on postoperative pain and analgesic requirements.

Materials and methods

A randomized controlled trial was conducted at a tertiary care center in India involving 72 patients undergoing laparoscopic IPOM plus. Patients were randomized into two groups: Group I received laparoscopic-guided TAP block, while Group II received standard general anesthesia without TAP block. Pain scores were assessed at 6, 12, and 24 h postoperatively using the numerical rating scale. Postoperative analgesic requirements were also recorded.

Results

Group I demonstrated significantly lower pain scores at 6 and 24 h postoperatively compared to Group II. The need for additional analgesics was significantly lower in Group I (13.8%) compared to Group II (72.2%). There were no significant differences in age, BMI, duration of surgery, or other demographic characteristics between the two groups.

Conclusion

The findings of this randomized controlled trial demonstrate the effectiveness of laparoscopic-guided TAP blocks in reducing postoperative pain and analgesic requirements after laparoscopic IPOM plus.

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References

  1. McGreevy JM, Goodney PP, Birkmeyer CM et al (2003) A prospective study comparing the complication rates of laparoscopic and open ventral hernia repairs. Surg Endosc 17:1778–1780

    Article  CAS  PubMed  Google Scholar 

  2. DeMaria EJ, Moss JM, Sugerman HJ (2000) Laparoscopic intraperital polytetrafluoroethylene (PTFE) prosthetic patch repair of ventral hernia. Surg Endosc 14:326–329

    Article  CAS  PubMed  Google Scholar 

  3. Carbajo MA, Martin del Olmo JC, Blanco JI et al (1999) Laparoscopic treatment vs open surgery in the solution of major incisional and abdominal wall hernias with mesh. Surg Endosc 13:250–252

    Article  CAS  PubMed  Google Scholar 

  4. Olmi S, Magnone S, Erba L et al (2005) The results of laparoscopic versus open abdominal and incisional hernia repair. JSLS 9:189–195

    PubMed  PubMed Central  Google Scholar 

  5. Olmi S, Scaini A, Cesana C et al (2007) Laparoscopic versus open incisional hernia repair an open randomized controlled study. Surg Endosc 21:555–559

    Article  CAS  PubMed  Google Scholar 

  6. Lamanto D, Iyer SG, Shabbir A et al (2006) Laparoscopic versus open ventral hernia mesh repair: a prospective study. Surg Endosc 20:1030–1035

    Article  Google Scholar 

  7. Warren JA, Carbonell AM, Jones LK et al (2019) Length of stay and opioid dose requirement with transversus abdominis plane block vs epidural analgesia for ventral hernia repair. J Am Coll Surg 228(4):680–686

    Article  PubMed  Google Scholar 

  8. Saber AA, Elgamal MH, Rao AJ et al (2009) Early experience with lidocaine patch for postoperative pain control after laparoscopic ventral hernia repair. Int J Surg 7:36–38

    Article  PubMed  Google Scholar 

  9. Rosen MJ, Duperier T, Marks J et al (2009) Prospective randomized double-blind placebo-controlled trial of postoperative elastomeric pain pump devices used after laparoscopic ventral hernia repair. Surg Endosc 23:2637–2643

    Article  PubMed  Google Scholar 

  10. Walter CJ, Maxwell-Armstrong C, Pinkney TD et al (2013) A randomized controlled trial of the efficacy of ultrasound guided transversus abdominis plane (TAP) block in laparoscopic colorectal surgery. Surg Endosc 27:2366–2372

    Article  PubMed  Google Scholar 

  11. El-Dawlatly AA, Turkistani A, Kettner SC et al (2009) Ultrasound guided transversus abdominis plane block: description of a new technique and comparison with conventional systemic analgesia during laparoscopic cholecystectomy. Br J Anaesth 102:763–767

    Article  CAS  PubMed  Google Scholar 

  12. Sinha A, Jayaraman L, Punhani D (2013) Efficacy of ultrasound guided transversus abdominis plane block after laparoscopic bariatric surgery: a double blind, randomized, controlled study. Obes Surg 23:548–553

    Article  PubMed  Google Scholar 

  13. Rafi AN (2001) Abdominal field block: a new approach via the Lumbar triangle. Anesthesia 56(10):1024–1026. https://doi.org/10.1046/j.13652044.2001.02279-40.x

    Article  CAS  Google Scholar 

  14. Dhand NK, Khatkar MS (2014) Statulator: an online statistical calculator. Sample size calculator for comparing two independent means

  15. Fields AC, Gonzalez DO, Chin EH, Nguyen SQ, Zhang LP, Divino CM (2015) Laparoscopic-assisted transversus abdominis plane block for postoperative pain control in laparoscopic ventral hernia repair: a randomized controlled trial. J Am Coll Surg 221(2):462–469. https://doi.org/10.1016/j.jamcollsurg.2015.04.007

    Article  PubMed  Google Scholar 

  16. Eswaran K, Kaderi ASA, Patel RD et al (2021) Laparoscopic transversus abdominis plane block with rectus block for postoperative analgesia in laparoscopic ventral hernia repair: a novel approach. Res Innov Anesth 6(1):17–20

    Article  Google Scholar 

  17. Andresen K, Rosenberg J (2018) Management of chronic pain after hernia repair. J Pain Res 5(11):675–681. https://doi.org/10.2147/JPR.S127820

    Article  Google Scholar 

  18. Werner MU, Kongsgaard UEI (2014) Defining persistent postsurgical pain: is an update required? Br J Anaesth 113(1):1–4

    Article  CAS  PubMed  Google Scholar 

  19. Andersen HL, Gyrn J, Moller L et al (2013) Continuous saphenous nerve block as supplement to single-dose local infiltration analgesia for postoperative pain management after total knee arthroplasty. Reg Anesth Pain Med 38:106–111

    Article  CAS  PubMed  Google Scholar 

  20. Essving P, Axelsson K, Kjellberg J et al (2009) Reduced hospital stay, morphine consumption, and pain intensity with local infiltration analgesia after unicompartmental knee arthroplastyda randomized double-blind study of 40 patients. Acta Orthop 80:213–219

    Article  PubMed  PubMed Central  Google Scholar 

  21. Eriksen JR, Poornoroozy P, Jorgensen LN et al (2009) Pain, quality of life and recovery after laparoscopic ventral hernia repair. Hernia 13:13–21

    Article  CAS  PubMed  Google Scholar 

  22. Salman AE, Yetisir F, Yurekli B et al (2013) The efficacy of the semi blind approach of transversus abdominis plane block on postoperative analgesia in patients undergoing inguinal hernia repair: a prospective randomized double-blind study. Local Reg Anesth 6:1–7

    CAS  PubMed  PubMed Central  Google Scholar 

  23. Ra YS, Kim CH, Lee GY et al (2010) The analgesic effect of the ultrasound-guided transverse abdominis plane block after laparoscopic cholecystectomy. Korean J Anesthesiol 58:362–368

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Milone M, Di Minno MN, Musella M et al (2013) Outpatient inguinal hernia repair under local anesthesia: feasibility and efficacy of ultrasound-guided transversus abdominis plane block. Hernia 17:749–755

    Article  CAS  PubMed  Google Scholar 

  25. Hosgood SA, Thiyagarajan UM, Nicholson HF et al (2012) Randomized clinical trial of transversus abdominis plane block versus placebo control in live-donor nephrectomy. Transplantation 94:520–525

    Article  CAS  PubMed  Google Scholar 

  26. McDonnell JG, Curley G, Carney J et al (2008) The analgesic efficacy of transversus abdominis plane block after cesarean delivery: a randomized controlled trial. Anesth Analg 106:186–189

    Article  CAS  PubMed  Google Scholar 

  27. Siddiqui MRS, Sajid MS, Uncles DR et al (2011) A meta-analysis on the clinical effectiveness of transversus abdominis plane block. J Clin Anesth 23:7–14

    Article  PubMed  Google Scholar 

  28. Kim MG, Kim SI, Ok SY, Kim SH, Lee SJ, Park SY, Lee SM, Jung BI (2012) The analgesic effect of ultrasound-guided transverse abdominis plane block after laparoscopic totally extraperitoneal hernia repair. Korean J Anesthesiol 63(3):227–232. https://doi.org/10.4097/kjae.2012.63.3.227

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Gao T, Zhang JJ, Xi FC, Shi JL, Lu Y, Tan SJ, Yu WK (2017) Evaluation of transversus abdominis plane (TAP) block in hernia surgery: a meta-analysis. Clin J Pain 33:369–375

    Article  PubMed  Google Scholar 

  30. Bharti N, Kumar P, Bala I et al (2011) The efficacy of a novel approach to transversus abdominis plane block for postoperative analgesia after colorectal surgery. Anesth Analg 112:1504–1508

    Article  CAS  PubMed  Google Scholar 

  31. Farooq M, Carey M (2008) A case of liver trauma with a blunt regional anesthesia needle while performing transversus abdominis plane block. Reg Anesth Pain Med 33:274–275

    Article  PubMed  Google Scholar 

  32. McDermott G, Korba E, Mata U et al (2012) Should we stop doing blind transversus abdominis plane blocks? Br J Anaesth 108:499–502

    Article  CAS  PubMed  Google Scholar 

  33. Niraj G, Searle A, Mathews M et al (2009) Analgesic efficacy of ultrasound-guided transversus abdominis plane block in patients undergoing open apendicectomy. Br J Anaesth 103:601–605

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgical Gastroenterology, Gem Hospital and Research Institute, Coimbatore, Tamil Nadu, India

    V. P. Nalankilli, P. J. Christopher, H. Motati, S. Balasubramanian & S. K. Ganapathi

  2. Department of Surgical Gastroenterology and Liver Transplant, Gem Hospital and Research Institute, Coimbatore, Tamil Nadu, India

    A. V. Natesan

  3. Gem Hospital and Research Institute, Coimbatore, Tamil Nadu, India

    P. Chinnusamy

Authors
  1. V. P. Nalankilli
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  2. P. J. Christopher
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  3. H. Motati
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  4. S. Balasubramanian
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  5. S. K. Ganapathi
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  6. A. V. Natesan
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  7. P. Chinnusamy
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Corresponding author

Correspondence to P. J. Christopher.

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Nil.

Ethical approval

Institutional ethics committee approval was obtained before starting the study, with reference number GEMREC01012024.

Informed consent

Informed consent was obtained from all the patients.

Human and animal rights statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Nalankilli, V.P., Christopher, P.J., Motati, H. et al. A randomized controlled trial on the effectiveness of laparoscopic-guided transversus abdominis plane block in patients undergoing laparoscopic IPOM plus. Hernia (2024). https://doi.org/10.1007/s10029-024-03016-w

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