The Effect Of Ultrasound Guided Transverse Abdominis Plane (TAP) Block On Chronic Post-operative Pain And CRP For Patients Undergoing Tension Free Inguinal Hernia Repair

Background:Chronic postoperative pain is one of the common complication following inguinal hernia repair.TAP block is a regional anesthesia technique which can be used for all kinds of lower abdominal surgeries including hernia repair.This technique combined with general anesthesia may reduce the occurrence of chronic postoperative pain following hernia repair.Objective:To evaluate the effect of TAP block for chronic postoperative pain for patients undergoing tension free inguinal hernia repair surgery.Methods:Total number of 120 consecutive male Patients were scheduled for elective tension free inguinal hernia repair.They were randomly divided into two groups,TAP block group(T)and Control group(C).A standard general anesthetic was administered to all the patients in both the groups.Whereas for the Patients in group(T),Ultrasound guided TAP block was administered using 20ml of 3.75%of Ropivacaine prior to the incision.Pain was assessed by using Visual analogue score(VAS)prior to the day of surgery,and 24hours,48hours postoperatively whereas Numeric rating scale(NRS)was used to evaluate pain at 1 week,1 month and 3 months postoperatively.C-reactive protein prior to the surgery and 24 hours postoperative were recorded.Results:Among the 60 patients in group(T)only 5 patients(8.33%)complained of pain at 3 months postoperatively.Whereas among 60 patients in group(C)14 patients(23.33%)complained of pain at 3 months postoperatively.P-value was noted<0.05.Similarly,the pain scores were lower in group T at 24 hours,48 hours and 1 week,P-value was noted<0.05 in all three periods.However,during 1 month,although the number of patients complaining of pain were higher in group(C)no any statistically significant difference was noted(P>0.05).Postoperative CRP after 24 hours was increased in both the groups compared to preoperative(P>0.05).Although CRP was increased more in group(C)than in group(T)no statistically difference was(P>0.05).Conclusion:TAP block is a regional anesthesia which when combined with general anesthesia could be a routine anesthesia technique for patients undergoing hernia repair or lower abdominal surgery.We believe that Ultrasound guided TAP block when combined with general anesthesia is an effective method in preventing the development of chronic pain after tension free inguinal hernia repair.