Journal of Research & Innovation in Anesthesia

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VOLUME 6 , ISSUE 1 ( January-June, 2021 ) > List of Articles

Original Article

Laparoscopic Transversus Abdominis Plane Block with Rectus Block for Postoperative Analgesia in Laparoscopic Ventral Hernia Repair: A Novel Approach

Kala Eswaran, Abdeali SA Kaderi, Rajendra D Patel, Sameer A Rege, Jayanti A Bhate, Pramod S Manohar

Keywords : Hernia, Postoperative pain management, TAP block

Citation Information : Eswaran K, Kaderi AS, Patel RD, Rege SA, Bhate JA, Manohar PS. Laparoscopic Transversus Abdominis Plane Block with Rectus Block for Postoperative Analgesia in Laparoscopic Ventral Hernia Repair: A Novel Approach. Res Inno in Anesth 2021; 6 (1):17-20.

DOI: 10.5005/jp-journals-10049-0106

License: CC BY-NC 4.0

Published Online: 30-07-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Ventral hernia repair remains one of the common procedures performed by general surgeons. Laparoscopic ventral hernia repair with intraperitoneal on lay mesh (IPOM) PLUS technique has become standard care in hernia repair surgery. Postoperative pain management is the key factor in enhanced recovery after surgery (ERAS). Transversus abdominis plane (TAP) blocks and rectus blocks have succeeded in reducing the opioid analgesics consumption as well as the pain score after ventral hernia repairs. Anesthetic drugs can be delivered into this plane by the conventional blind, USG-guided, or assisted with laparoscopy direct vision. USG-guided blocks require an ultrasound machine, an expert sonologist in operation theater which may not be available. Case presentation/Context: We performed laparoscopic TAP block with rectus block in 70 patients undergoing laparoscopic ventral hernia repair by IPOM, IPOM-Plus, and EACS-IPOM plus and observed the efficacy and effectiveness of the procedure in relieving postoperative pain using VAS scoring system as well as multiple parameters that indicate faster postoperative recovery of the patient. Conclusion: Laparoscopy-guided TAP block and rectus block provide a promising modality of postoperative analgesia in laparoscopic ventral hernia repair. Key messages: With a significantly low postoperative pain score, it can be used as a modality of drug delivery in the areas where intraoperative USG machines, expert sonologist, or anesthetist specialized in ultrasound are not available due to cost issues or issues of PCPNDT.


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