COMPARISON OF EFFICACY OF ILIOINGUINAL / ILIOHYPOGASTRIC NERVE BLOCK AND TRANSVERSUS ABDOMINIS PLANE BLOCK FOR POSTOPERATIVE PAIN MANAGEMENT IN PATIENTS UNDERGOING OPEN INGUINAL HERNIA REPAIR: A RETROSPECTIVE COHORT STUDY

Abstract

Arun Sundaram, Anderson Abzalon, Vipin Balakrishnan

BACKGROUND Postoperative pain in inguinal hernia repair is moderate to severe and is associated with chronic postoperative pain. Ilioinguinal, Iliohypogastric (IIN/IHN) block or Transversus Abdominis Plane (TAP) Block can be used to treat this pain. Recent evidences suggested that ultrasound-guided IIIH block is more effective than TAP block. This retrospective study compared the postoperative analgesia among the ultrasound-guided IIN/IHN block and USG guided TAP block for inguinal hernia repair surgery in adults. We wanted to compare mean duration of requirement of rescue analgesia and postoperative pain scores in patients receiving USG guided Tap block vs ilioinguinal/iliohypogastric block. METHODS All charts of men 18 years above and up to 60 years, with ASA grade of 1-3, who underwent elective inguinal hernia surgeries under spinal anaesthesia, where included in the study. 60 patients were identified and assigned into two group. Group 1 Patients received TAP block and the group 2 Patients received the ilioinguinal and iliohypogastric nerve block. All cases received subarachnoid block with 0.5% bupivacaine without any adjuvants as the primary mode of anaesthesia. Perioperative data of the subjected patients were collected retrospectively including age, height, weight, ASA classification, hemodynamic parameters, VAS pain scores and the time for rescue analgesia. RESULTS The mean duration (in minutes) to require rescue analgesia was found to be 320.6 ± 114.2 (min) in group 1 and 410 ± 116.24 (min) in group 2. On comparison of these two values the difference in mean time to rescue analgesic requirement was statistically significant (p<0.005). CONCLUSIONS Following inguinal hernia repair surgery, IIN/IHN block provides more effective postoperative analgesia than TAP block.

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