Evaluation of the effects of subcostal transversus abdominis plane block on acute and subacute pain development following inguinal herniography: Randomized clinical study

Çiğdem Akyol Beyoğlu1, Aylin Özdilek1, Emre Erbabacan1, Elif Aybike Özmumcu1, Birsel Ekici1, Güniz Köksal1, Fatiş Altıntaş1, Sevim Purisa2

1Department of Anesthesiology and Reanimation, Istanbul University Cerrahpaşa Faculty of Medicine, Istanbul, Turkey
2Department of Pharmaceutical Technology, Istanbul University Faculty of Pharmacy, Istanbul Turkey

Keywords: Inguinal herniography, postoperative subacute pain; subcostal transversus abdominis plane block.

Abstract

Objectives: The effect of subcostal transversus abdominis plane (TAP) block on postoperative pain is contradictive. The aim of this study was to evaluate the effect of subcostal TAP block on subacute pain in patients who have undergone inguinal herniography.
Methods: Patients aged between 18 and 75 years with American Society of Anesthesiologists 1–3 and who were to undergo elective unilateral inguinal herniography with mesh under general anesthesia were included. Fifty patients were under an intravenous analgesic regimen (group I) and 50 patients underwent subcostal TAP block postoperatively in addition to the intravenous analgesic regimen (group II). The primary outcome measure was pain scores 1 month postoperatively by comparing Numerical Rating Scale values with the Mann–Whitney U test between groups I and II. Secondary outcome measures were life qualification scores 1 month postoperatively and pain scores 24 h and 15 days postoperatively.
Results: Postoperative 15th-min; 1st-, 6th-, 12th-, and 24th-h; 15th-day (p=0.00); and 1st-month Numerical Rating Scale values were significantly lower in group II than in group I (p=0.02). No significant difference was observed between the groups in terms of LQS 15 days postoperatively (p=0.013). On group comparison, LQS was higher in the 1st month than at the 15th day postoperatively in group I (p=0.201).
Conclusion: Subcostal TAP block provides an effective postoperative pain treatment in the acute period and in the 1st postoperative month in patients undergoing inguinal herniography.