title: Is transverse abdominis plane block effective following local anesthetic infiltration in laparoscopic totally extraperitoneal hernia repair?
abstract: BACKGROUND
  Transverse abdominis plane (TAP) block can be recommended as a multimodal method to reduce postoperative pain in laparoscopic abdominal surgery. However, it is unclear whether TAP block following local anesthetic infiltration is effective. We planned this study to evaluate the effectiveness of the latter technique in laparoscopic totally extraperitoneal hernia repair (TEP).
  
  
  METHODS
  We randomly divided patients into two groups: the control group (n = 37) and TAP group (n = 37). Following the induction of general anesthesia, as a preemptive method, all of the patients were subjected to local anesthetic infiltration at the trocar sites, and the TAP group was subjected to ultrasound-guided bilateral TAP block with 30 ml of 0.375% ropivacaine in addition before TEP. Pain was assessed in the recovery room and post-surgery at 4, 8, and 24 h. Additionally, during the postoperative 24 h, the total injected dose of analgesics and incidence of nausea were recorded.
  
  
  RESULTS
  On arrival in the recovery room, the pain score of the TAP group (4.33 ± 1.83) was found to be significantly lower than that of the control group (5.73 ± 2.04). However, the pain score was not significantly different between the TAP group and control group at 4, 8, and 24 h post-surgery. The total amounts of analgesics used in the TAP group were significantly less than in the control group. No significant difference was found in the incidence of nausea between the two groups.
  
  
  CONCLUSIONS
  TAP block following local infiltration had a clinical advantage only in the recovery room.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea.
authors.forename: Mun Gyu
authors.initials: MG
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea.
authors.forename: Soon Im
authors.initials: SI
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea.
authors.forename: Si Young
authors.initials: SY
authors.lastname: Ok
authors.affiliation: Department of Anesthesiology and Pain Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea.
authors.forename: Sang Ho
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea.
authors.forename: Se-Jin
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea.
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Park
authors.affiliation: Department of Anesthesiology and Pain Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea.
authors.forename: Jae-Hwa
authors.initials: JH
authors.lastname: Yoo
authors.affiliation: Department of Anesthesiology and Pain Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea.
authors.forename: Ana
authors.initials: A
authors.lastname: Cho
authors.affiliation: Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea.
authors.forename: Kyung Yul
authors.initials: KY
authors.lastname: Hur
authors.affiliation: Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea.
authors.forename: Myung Jin
authors.initials: MJ
authors.lastname: Kim
keywords: Hernia; Repair; Ropivacaine; Transverse; Ultrasonography