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CC BY-NC-ND 4.0 · International Journal of Recent Surgical and Medical Sciences 2023; 09(01): 001-005
DOI: 10.1055/s-0042-1747922
Original Article

Evaluation of Effectiveness of Preemptive Intravenous Analgesics versus Postoperative TAP Block in Unilateral Inguinal Hernioplasty—A Prospective Randomized Double-Blind Clinical Trial

C. N. Navya
1   Department of Anesthesiology, SriMuthukumaran Medical College Hospital and Research Institute, Chennai, Tamil Nadu, India
,
V. Srisanthanakrishnan 
2   Department of Community Medicine, SriMuthukumaran Medical College Hospital and Research Institute, Chennai, Tamil Nadu, India
,
P. M. Safneedha
1   Department of Anesthesiology, SriMuthukumaran Medical College Hospital and Research Institute, Chennai, Tamil Nadu, India
,
V. Ranganathan
1   Department of Anesthesiology, SriMuthukumaran Medical College Hospital and Research Institute, Chennai, Tamil Nadu, India
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Abstract

Aim The aim of this study was to compare the extent of analgesia in terms of duration of analgesia and requirement of postoperative analgesics with preemptive analgesia and transversus abdominis plane (TAP) block in patients undergoing inguinal hernioplasty.

Materials and Methods Ninety male patients aged between 18 and 65 years of American Society of Anesthesiologists grades I and II undergoing open inguinal hernioplasty were randomly allocated to three comparable groups of 30 each. Control group (group C) received normal saline; preemptive group (group P) received inj. paracetamol, inj. diclofenac, and inj. Lignocaine; and TAP group (group T) received TAP block with 20 mL of 0.25% bupivacaine at the end of surgery. Parameters recorded were verbal numerical rating scale (VNRS) at rest at 4, 12, 24, and 48 hours and VNRS on movement at 12, 24, and 48 hours; heart rate and mean arterial pressure at 0, 4, 12, and 48 hours; time for first analgesic request; and total doses of analgesics consumed at 24 hours.

Results Demographic data were comparable. VNRS on movement and number of doses of analgesics consumed at 24 hours were statistically less in group T (4.80 ± .761 hours); time for first request of analgesia was longer and this group had better patient satisfaction scores compared with other groups.

Conclusion Both groups P and T provided better VNRS scores compared with group C. TAP block provided better VNRS scores on movement at 24 hours, lesser analgesic requirement, and better patient satisfaction score compared with other groups.

Keywords

preemptive analgesia - inguinal hernioplasty - postoperative analgesia - TAP block

Financial Support

Nil.




Publication History

Article published online:
29 June 2022

© 2022. Medical and Surgical Update Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Kang H, Hong SH, Kim H, Kim ES, Shin HJ. Pre- and post-operative patient\'s reactions to postoperative pain. Chungbuk Med J 2007; 17: 182-189
    Google Scholar
  • 2 Kehlet H. Surgical stress: the role of pain and analgesia. Br J Anaesth 1989; 63 (02) 189-195
    CrossrefPubMedGoogle Scholar
  • 3 Nir RR, Nahman-Averbuch H, Moont R, Sprecher E, Yarnitsky D. Preoperative preemptive drug administration for acute postoperative pain: a systematic review and meta-analysis. Eur J Pain 2016; 20 (07) 1025-1043
    CrossrefPubMedGoogle Scholar
  • 4 McDonnell JG, O'Donnell B, Curley G, Heffernan A, Power C, Laffey JG. The analgesic efficacy of transversus abdominis plane block after abdominal surgery: a prospective randomized controlled trial. Anesth Analg 2007; 104 (01) 193-197
    CrossrefPubMedGoogle Scholar
  • 5 Woolf CJ, Salter MW. Neuronal plasticity: increasing the gain in pain. Science 2000; 288 (5472): 1765-1769
    CrossrefPubMedGoogle Scholar
  • 6 Woolf CJ, Chong MS. Preemptive analgesia–treating postoperative pain by preventing the establishment of central sensitization. Anesth Analg 1993; 77 (02) 362-379
    CrossrefPubMedGoogle Scholar
  • 7 Kissin I. Preemptive analgesia. Anesthesiology 2000; 93 (04) 1138-1143
    CrossrefPubMedGoogle Scholar
  • 8 Fischer S, Troidl H, MacLean AA, Koehler L, Paul A. Prospective double-blind randomised study of a new regimen of pre-emptive analgesia for inguinal hernia repair: evaluation of postoperative pain course. Eur J Surg 2000; 166 (07) 545-551
    CrossrefPubMedGoogle Scholar
  • 9 Dunn LK, Durieux ME. Perioperative use of intravenous lidocaine. Anesthesiology 2017; 126 (04) 729-737
    CrossrefPubMedGoogle Scholar
  • 10 García-Navia JT, Tornero López J, Egea-Guerrero JJ, Vilches Arenas A, Vázquez Gutiérrez T. Effect of a single dose of lidocaine and ketamine on intraoperative opioids requirements in patients undergoing elective gynecological laparotomies under general anesthesia. A randomized, placebo controlled pilot study. Farm Hosp 2016; 40 (01) 44-51
    PubMedGoogle Scholar
  • 11 Surender AP, Arora P, Khurana G, Sachan PK. Comparison of postoperative quality of recovery and pain relief with preoperative single-dose dexamethasone and lignocaine after laparoscopic cholecystectomy. Anesth Essays Res 2018; 12 (03) 630-635
    CrossrefPubMedGoogle Scholar
  • 12 McDonnell JG, O'Donnell BD, Farrell T. et al. Transversus abdominis plane block: a cadaveric and radiological evaluation. Reg Anesth Pain Med 2007; 32 (05) 399-404
    PubMedGoogle Scholar
  • 13 Aweke Z, Seyoum F, Shitemaw T, Doba DN. Comparison of preemptive paracetamol, paracetamol-diclofenac & paracetamol-tramadol combination on postoperative pain after elective abdominal surgery under general anesthesia, Ethiopia: a randomized control trial study, 2018. BMC Anesthesiol 2020; 20 (01) 191
    CrossrefPubMedGoogle Scholar
  • 14 Ibrahima TH, Abdellatifa MK, Osamaa FM. Efficacy of the transversus abdominis plane block using 30 ml bupivacaine 0.25% in reducing postoperative fentanyl requirements in renal transplant recipients. Ain-Shams Journal of Anaesthesiology. 2017; 10 (01) 258-263
    Google Scholar
  • 15 Aguirre-Ospina OD, Gómez-Salgado JC, Chaverra D, Alzate M, Ríos-Medina ÁM. Bloqueo del planotransversodel abdomen en herniorrafia inguinal. Ensayoclínicocontrolado. Rev ColombAnestesiol. 2017; 45: 159-165
    Google Scholar
  • 16 Canakci E, Cihan M, Altinbas A, Cebeci Z, Gultekin A, Tas N. Efficacy of ultrasound-guided Transversus Abdominis Plane (TAP) block in inguinal hernia surgery and the immunomodulatory effects of proinflammatory cytokines: prospective, randomized, placebo-controlled study. Braz J Anesthesiol 2021; 71 (05) 538-544
    PubMedGoogle Scholar