Comparison of the analgesic efficacy of two different fascial blocks in patients undergoing laparoscopic inguinal hernia surgery: A randomized control trial

Background and Aims: Moderate-to-severe intensity pain is reported on the first day following lower abdominal surgery. No study has compared transversus abdominis plane (TAP) block with retrolaminar block (RLB) in laparoscopic inguinal hernia surgery for postoperative pain relief. Material and Metho...

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Main Authors: Vanita Ahuja, Aastika Mahajan, Deepak Thapa, Sukanya Mitra, Deepika Gupta, Sanjay Gupta, Rajeev Sharma, Simrandeep Singh
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-04-01
Series:Journal of Anaesthesiology Clinical Pharmacology
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Online Access:https://journals.lww.com/10.4103/joacp.joacp_424_22
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author Vanita Ahuja
Aastika Mahajan
Deepak Thapa
Sukanya Mitra
Deepika Gupta
Sanjay Gupta
Rajeev Sharma
Simrandeep Singh
author_facet Vanita Ahuja
Aastika Mahajan
Deepak Thapa
Sukanya Mitra
Deepika Gupta
Sanjay Gupta
Rajeev Sharma
Simrandeep Singh
author_sort Vanita Ahuja
collection DOAJ
description Background and Aims: Moderate-to-severe intensity pain is reported on the first day following lower abdominal surgery. No study has compared transversus abdominis plane (TAP) block with retrolaminar block (RLB) in laparoscopic inguinal hernia surgery for postoperative pain relief. Material and Methods: In this prospective, randomized trial, 42 male patients of American Society of Anesthesiologists (ASA) physical status I and II, aged 18–65 years, and having a BMI <40 kg/m2 received TAP or RLB following laparoscopic inguinal hernia surgery. A standard general anesthetic technique was performed. Patients were randomized into two groups: single-shot TAP block (group I) (n = 21) or the RLB (group II) (n = 21) with bilateral 20 ml of 0.375% ropivacaine. Postoperatively, IV paracetamol 1 g was administered as rescue analgesia. Postoperative cumulative Visual Analogue Scale (VAS) score 24 hours after surgery was considered as the primary outcome. Results: Postoperative cumulative VAS score at rest at 24 h, represented as mean ± S.D (95% CI), in the TAP block group was 3.54 ± 3.04 (2.16–4.93) and in the RLB group was 6.09 ± 4.83 (3.89–8.29). P value was 0.112 and VAS on movement was 7.95 ± 3.41 (6.39–9.50 [2.5–15.0]) in TAP block group, whereas P value was 0.110 and VAS on movement was 10.83 ± 5.51 (8.32–13.34) in the RLB group. Conclusion: Similar postoperative cumulative pain score on movement at 24 h was present in patients receiving TAP block or RLB. However, VAS score at rest and on movement was reduced in patients receiving TAP block at 18 and 24 h postoperatively.
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spelling doaj-art-abccdae5dd69472b8557b949333f8d722025-08-20T02:36:49ZengWolters Kluwer Medknow PublicationsJournal of Anaesthesiology Clinical Pharmacology2231-27302024-04-0140222823410.4103/joacp.joacp_424_22Comparison of the analgesic efficacy of two different fascial blocks in patients undergoing laparoscopic inguinal hernia surgery: A randomized control trialVanita AhujaAastika MahajanDeepak ThapaSukanya MitraDeepika GuptaSanjay GuptaRajeev SharmaSimrandeep SinghBackground and Aims: Moderate-to-severe intensity pain is reported on the first day following lower abdominal surgery. No study has compared transversus abdominis plane (TAP) block with retrolaminar block (RLB) in laparoscopic inguinal hernia surgery for postoperative pain relief. Material and Methods: In this prospective, randomized trial, 42 male patients of American Society of Anesthesiologists (ASA) physical status I and II, aged 18–65 years, and having a BMI <40 kg/m2 received TAP or RLB following laparoscopic inguinal hernia surgery. A standard general anesthetic technique was performed. Patients were randomized into two groups: single-shot TAP block (group I) (n = 21) or the RLB (group II) (n = 21) with bilateral 20 ml of 0.375% ropivacaine. Postoperatively, IV paracetamol 1 g was administered as rescue analgesia. Postoperative cumulative Visual Analogue Scale (VAS) score 24 hours after surgery was considered as the primary outcome. Results: Postoperative cumulative VAS score at rest at 24 h, represented as mean ± S.D (95% CI), in the TAP block group was 3.54 ± 3.04 (2.16–4.93) and in the RLB group was 6.09 ± 4.83 (3.89–8.29). P value was 0.112 and VAS on movement was 7.95 ± 3.41 (6.39–9.50 [2.5–15.0]) in TAP block group, whereas P value was 0.110 and VAS on movement was 10.83 ± 5.51 (8.32–13.34) in the RLB group. Conclusion: Similar postoperative cumulative pain score on movement at 24 h was present in patients receiving TAP block or RLB. However, VAS score at rest and on movement was reduced in patients receiving TAP block at 18 and 24 h postoperatively.https://journals.lww.com/10.4103/joacp.joacp_424_22analgesiaherniainguinalnerve blockspain intensityropivacainetransversus abdominisultrasonographyvisual analogue pain scale
spellingShingle Vanita Ahuja
Aastika Mahajan
Deepak Thapa
Sukanya Mitra
Deepika Gupta
Sanjay Gupta
Rajeev Sharma
Simrandeep Singh
Comparison of the analgesic efficacy of two different fascial blocks in patients undergoing laparoscopic inguinal hernia surgery: A randomized control trial
Journal of Anaesthesiology Clinical Pharmacology
analgesia
hernia
inguinal
nerve blocks
pain intensity
ropivacaine
transversus abdominis
ultrasonography
visual analogue pain scale
title Comparison of the analgesic efficacy of two different fascial blocks in patients undergoing laparoscopic inguinal hernia surgery: A randomized control trial
title_full Comparison of the analgesic efficacy of two different fascial blocks in patients undergoing laparoscopic inguinal hernia surgery: A randomized control trial
title_fullStr Comparison of the analgesic efficacy of two different fascial blocks in patients undergoing laparoscopic inguinal hernia surgery: A randomized control trial
title_full_unstemmed Comparison of the analgesic efficacy of two different fascial blocks in patients undergoing laparoscopic inguinal hernia surgery: A randomized control trial
title_short Comparison of the analgesic efficacy of two different fascial blocks in patients undergoing laparoscopic inguinal hernia surgery: A randomized control trial
title_sort comparison of the analgesic efficacy of two different fascial blocks in patients undergoing laparoscopic inguinal hernia surgery a randomized control trial
topic analgesia
hernia
inguinal
nerve blocks
pain intensity
ropivacaine
transversus abdominis
ultrasonography
visual analogue pain scale
url https://journals.lww.com/10.4103/joacp.joacp_424_22
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