title: Ultrasound-guided transversalis fascia plane block versus anterior transversus abdominis plane block in outpatient inguinal hernia repair.
abstract: BACKGROUND
  The aim of the study was to assess the effectiveness of ultrasound-guided transversalis fascia plane block (TFP) compared to anterior transversus abdominis plane block (TAP-A) for post-operative analgesia in outpatient unilateral inguinal hernia repair.
  
  
  METHODS
  Retrospective observational study conducted on ASA I-II patients. Two groups (TAP-A and TFP), which were given 30ml of 0.25% levobupivacaine prior to surgical incision. The primary endpoint was the post-operative pain evaluated by verbal numerical scale (VRN at rest and movement) at 10, 30, 60, 90min, coinciding with ambulation, and 24hours by telephone. An evaluation was also made of the sensory block level reached prior to surgery, the need for additional analgesia, side effects, ease of performing the technique, and the level of satisfaction of patients with the anaesthetic-analgesic technique.
  
  
  RESULTS
  A total of 61 patients were included, 30 patients in the TAP-A group and 31 in the TFP group. The analgesic efficacy obtained in both groups was similar, although some higher values were found in the VNR on moving in the TAP-A group, reaching statistical difference at 10minutes (P=.014) and 30minutes (P=.013) post-operatively. A higher level of sensory block was achieved in the TFP group than in the TAP-A group (P<.01). There were no significant differences in additional analgesia requirements, and the cumulative dose of morphine was similar in both groups in the post-operative period. There were no differences in side effects or complications. The technical ease of the block was similar in both groups and the level of satisfaction of patients very high.
  
  
  CONCLUSIONS
  Both blocks with a multimodal approach achieve good post-operative analgesia of inguinal hernia repair, are easy to perform and have few complications. TFP achieves the highest sensory level, but there are no differences in the requirements for additional analgesia.
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario Lucus Augusti, Lugo, España. Electronic address: jose.manuel.lopez.gonzalez@sergas.es.
authors.forename: J M
authors.initials: JM
authors.lastname: López-González
authors.affiliation: Servicio de Anestesiología y Reanimación, Complejo Hospitalario Universitario de A Coruña, La Coruña, España.
authors.forename: S
authors.initials: S
authors.lastname: López-Álvarez
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario Lucus Augusti, Lugo, España.
authors.forename: B M
authors.initials: BM
authors.lastname: Jiménez Gómez
authors.affiliation: Servicio de Anestesiología y Reanimación, Complejo Hospitalario Universitario de Vigo, Vigo, España.
authors.forename: I
authors.initials: I
authors.lastname: Areán González
authors.affiliation: Servicio de Anestesiología y Reanimación, Complejo Hospitalario Universitario de Vigo, Vigo, España.
authors.forename: G
authors.initials: G
authors.lastname: Illodo Miramontes
authors.affiliation: Servicio de Anestesiología y Reanimación, Complejo Hospitalario Universitario de Vigo, Vigo, España.
authors.forename: L
authors.initials: L
authors.lastname: Padín Barreiro
mesh_terms: D000009:Abdominal Muscles; D005205:Fascia; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D009407:Nerve Block; D010045:Outpatients; D010149:Postoperative Pain; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional
keywords: Analgesia multimodal; Bloqueo del plano de la fascia transversalis; Bloqueo del plano transverso abdominal; Cirugía ambulatoria; Hernia inguinal; Inguinal hernia; Multimodal analgesia; Outpatient surgery; Transversalis fascia plane block; Transversus abdominis plane block