Comparison of Tap Block vs Layer by Layer Local Anesthetic Infiltration Patients Undergoing Inguinal Hernia Repair

Objective: To compare analgesic efficacy of Transverses Abdominis plane block and layer by layer local anesthetic infiltration patients undergoing inguinal hernia repair. Study Design: Quasi-Experimental Study. Place and Duration of Study: Anesthesia Department, Combined Military Hospital, Rawalpindi Pakistan, from Feb to Jul 2022. Methodology: A total of 80 patients undergoing inguinal hernia repair under spinal anesthesia were enrolled in the study after random distribution and divided into two groups receiving localized wound infiltration (Group A) and receiving Transversus abdominis plane block (Group B). The primary determinants were request to first analgesia and mean total consumption of analgesia post-operatively. Additionally, determining variables were mean postoperative pain scores at 6, 12 and 24 hours. Results: A total of 80 patients were enrolled in the study with a mean age of 37.53±9.32 years. There was a significantly prolonged time before patient requested first analgesic dose in Transverses Abdominis plane block group as compared to WI group (244.9±66.6 mins vs. 160.3±19.9 mins with a p-value<0.001). Increased dosage of Injection Nalbuphine (26.5±1.74 mg vs. 20.4±1.45 mg, p-value<0.001) and Injection Ketorolac (75.4±6.52 mg vs. 66.7±4.66 mg, p-value<0.001) were consumed in WI group as compared to TAP block group respectively. Conclusion: TAP block achieves better analgesia when compared with WI as demonstrated increased time to first request for analgesic, lower pain scores and low total analgesic use on the zero post-operative day. The reduced total analgesic consumption can also potentially lead to lower side effect profile and increased satisfaction of patient in regards to postoperative pain control