Better timing of ultrasound-guided transversus abdominis plane block for early recovery after open inguinal herniorrhaphy: A prospective randomised controlled study

• Published in: Asian journal of surgery 2021-01, Vol.44 (1), p.254-261
• Main Authors: Shim, Jung-Woo, Ko, Jemin, Lee, Chul-Seung, Lee, Do-Sang, Park, Jaesik, Lee, Hyung Mook, Kim, Yong-Suk, Moon, Young Eun, Hong, Sang Hyun, Chae, Min Suk
• Format: Article
• Language: English
• Subjects: Open inguinal herniorrhaphy; Quality of Recovery-40 questionnaire; Transversus abdominis plane block
• ISSN: 1015-9584
• DOI: 10.1016/j.asjsur.2020.06.001

This study investigated the optimal timing of analgesic transversus abdominis plane (TAP) block in the operating room for better recovery quality using the Korean version of the Quality of Recovery-40 (QoR-40K) questionnaire in patients who had undergone open inguinal herniorrhaphy. This single-centre, prospective randomised controlled study included adult male patients who had an ASA physical status of I–II. A total of 80 patients were analysed. The patients were randomly assigned and classified into pre-incisional TAP (pre-TAP) block (n = 40) and post-incisional TAP (post-TAP) block (n = 40) groups. The quality of postoperative functional recovery and complications were compared between the two groups during 24 h postoperatively. Preoperative findings of the two groups were comparable. The global QoR-40K score was higher in the pre-TAP group than in the post-TAP group. Among sub-dimensions, scores of physical comfort and pain were higher in the pre-TAP group than in the post-TAP group. In the post-anaesthesia care unit, the pre-TAP group showed lower pain scores than the post-TAP block group. There was no severe pain in the pre-TAP group, but two patients (5.0%) in the post-TAP block group suffered severe pain. The pre-TAP group required lower doses of IV rescue opioid in the PACU than the post-TAP group. All patients were discharged from hospital on postoperative day 1 without surgical complications. The timing of analgesic TAP block may be of clinical importance to prevent postoperative pain and to improve the quality of early patient recovery following open inguinal herniorrhaphy.