Postoperative analgesic efficiency of transversus abdominis plane block after ventral hernia repair: A prospective, randomized, controlled clinical trial
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CHESOV, Ion, BELÎI, Adrian. Postoperative analgesic efficiency of transversus abdominis plane block after ventral hernia repair: A prospective, randomized, controlled clinical trial. In: Romanian Journal of Anaesthesia and Intensive Care, 2017, nr. 2(24), pp. 125-132. ISSN 2392-7518. DOI: https://doi.org/10.21454/rjaic.7518.242.chv
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Romanian Journal of Anaesthesia and Intensive Care
Numărul 2(24) / 2017 / ISSN 2392-7518

Postoperative analgesic efficiency of transversus abdominis plane block after ventral hernia repair: A prospective, randomized, controlled clinical trial

DOI: https://doi.org/10.21454/rjaic.7518.242.chv

Pag. 125-132

Chesov Ion, Belîi Adrian
 
”Nicolae Testemițanu” State University of Medicine and Pharmacy
 
Disponibil în IBN: 6 februarie 2018


Rezumat

Background and aims: Effective postoperative analgesia is a key element in reducing postoperative morbidity, accelerating recovery and avoiding chronic postoperative pain. The aim of this study was to evaluate the effectiveness of ultrasound-guided Transversus Abdominis Plane (TAP) block, performed before surgical incision, in providing postoperative analgesia for patients undergoing open ventral hernia repair under general anaesthesia. Methods: Seventy elective patients scheduled for open ventral hernia repair surgery under general anaesthesia were divided randomly into two equal groups: Group I received bilateral TAP block performed before surgical incision (n = 35); Group II received systemic postoperative analgesia with parenteral opioid (morphine) alone (n = 35). Postoperatively pain scores at rest and with movement, total morphine consumption and opioid related side effects were recorded. Results: Postoperative pain scores at rest and mobilization/cough were significantly higher in patients without TAP block (p < 0.05). Mean intraoperative fentanyl consumption was comparable between the two groups: 0.75 ± 0.31 mg in group I (TAP) and 0.86 ± 0.29 mg in group II (MO), p = 0.1299. Patients undergoing preincisional TAP block had reduced morphine requirements during the first 24 hours after surgery, compared to patients from group II, without TAP block (p = 0.0001). There was no difference in the incidence of opioid related side effects (nausea, vomiting) in the both groups during the first 24 postoperative hours. Conclusion: The use of preincisional ultrasound guided TAP block reduced the pain scores at rest and with movement/cough, opioid consumption and opioid-related side effects after ventral hernia repair when compared with opioid-only analgesia.

Cuvinte-cheie
Pain management, Postoperative pain, Ventral hernia,

Transversus abdominis plane block