{"title":"比较腹腔镜腹疝修补术中经腹平面阻滞和肝部浸润:一项随机对照试验。","authors":"Sourabh Singh, Himanshu Agrawal, Nikhil Gupta, Nitin Agarwal, Aditya Kumar, Shailesh Kumar","doi":"10.4103/jmas.jmas_382_24","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Adequate analgesia is of utmost importance for apposite in patients undergoing laparoscopic ventral hernia repair (LVHR) for smooth recovery. TAP block and port-site infiltration (PSI) are two most commonly employed methods for pain relief. Therefore, this study was done to compare laparoscopic-guided TAP block versus PSI for post-operative analgesia, hospital stay and rescue dose of analgesic in LVHR.</p><p><strong>Patients and methods: </strong>This single-blinded randomised controlled trial was done in a tertiary hospital of Delhi from 1 April 2023, to 1 August 2024. A total of 60 patients were enrolled. Randomisation was done using computer-generated random number table, and allotment was done using sequentially numbered opaque sealed envelopes. All patients >18 years of age with anterior abdominal wall hernia undergoing LVHR were included in the study. Patients with a history of opioid usage, patients with alcohol abuse within the past 6 months, patients with hernia size >6 cm were excluded from the study. Two groups included: test group (Group A) - laparoscopic-assisted TAP block (LTAP) and control Group (Group B) - port-site local anaesthesia infiltration (PSLAI).</p><p><strong>Results: </strong>In LVHR, the use of TAP blocks showed superior pain management compared to PSLAI (significantly lower VAS scores at 6, 12 and 24-h post-surgery in the LTAP group [P = 0.0031, 0.0037 and 0.00012, respectively]). LTAP was associated with a shorter hospital stay (P = 0.016) and less need for rescue analgesia (P = 0.031).</p><p><strong>Conclusion: </strong>Laparoscopic transverse abdominis plane block is superior to port-site local anaesthesia infiltration in providing effective post-operative analgesia.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.1000,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparing laparoscopic transversus abdominis plane block and port-site infiltration in laparoscopic ventral hernia repair: A randomised controlled trial.\",\"authors\":\"Sourabh Singh, Himanshu Agrawal, Nikhil Gupta, Nitin Agarwal, Aditya Kumar, Shailesh Kumar\",\"doi\":\"10.4103/jmas.jmas_382_24\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Adequate analgesia is of utmost importance for apposite in patients undergoing laparoscopic ventral hernia repair (LVHR) for smooth recovery. TAP block and port-site infiltration (PSI) are two most commonly employed methods for pain relief. Therefore, this study was done to compare laparoscopic-guided TAP block versus PSI for post-operative analgesia, hospital stay and rescue dose of analgesic in LVHR.</p><p><strong>Patients and methods: </strong>This single-blinded randomised controlled trial was done in a tertiary hospital of Delhi from 1 April 2023, to 1 August 2024. A total of 60 patients were enrolled. Randomisation was done using computer-generated random number table, and allotment was done using sequentially numbered opaque sealed envelopes. All patients >18 years of age with anterior abdominal wall hernia undergoing LVHR were included in the study. Patients with a history of opioid usage, patients with alcohol abuse within the past 6 months, patients with hernia size >6 cm were excluded from the study. Two groups included: test group (Group A) - laparoscopic-assisted TAP block (LTAP) and control Group (Group B) - port-site local anaesthesia infiltration (PSLAI).</p><p><strong>Results: </strong>In LVHR, the use of TAP blocks showed superior pain management compared to PSLAI (significantly lower VAS scores at 6, 12 and 24-h post-surgery in the LTAP group [P = 0.0031, 0.0037 and 0.00012, respectively]). LTAP was associated with a shorter hospital stay (P = 0.016) and less need for rescue analgesia (P = 0.031).</p><p><strong>Conclusion: </strong>Laparoscopic transverse abdominis plane block is superior to port-site local anaesthesia infiltration in providing effective post-operative analgesia.</p>\",\"PeriodicalId\":48905,\"journal\":{\"name\":\"Journal of Minimal Access Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2025-07-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Minimal Access Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4103/jmas.jmas_382_24\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Minimal Access Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4103/jmas.jmas_382_24","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
Comparing laparoscopic transversus abdominis plane block and port-site infiltration in laparoscopic ventral hernia repair: A randomised controlled trial.
Introduction: Adequate analgesia is of utmost importance for apposite in patients undergoing laparoscopic ventral hernia repair (LVHR) for smooth recovery. TAP block and port-site infiltration (PSI) are two most commonly employed methods for pain relief. Therefore, this study was done to compare laparoscopic-guided TAP block versus PSI for post-operative analgesia, hospital stay and rescue dose of analgesic in LVHR.
Patients and methods: This single-blinded randomised controlled trial was done in a tertiary hospital of Delhi from 1 April 2023, to 1 August 2024. A total of 60 patients were enrolled. Randomisation was done using computer-generated random number table, and allotment was done using sequentially numbered opaque sealed envelopes. All patients >18 years of age with anterior abdominal wall hernia undergoing LVHR were included in the study. Patients with a history of opioid usage, patients with alcohol abuse within the past 6 months, patients with hernia size >6 cm were excluded from the study. Two groups included: test group (Group A) - laparoscopic-assisted TAP block (LTAP) and control Group (Group B) - port-site local anaesthesia infiltration (PSLAI).
Results: In LVHR, the use of TAP blocks showed superior pain management compared to PSLAI (significantly lower VAS scores at 6, 12 and 24-h post-surgery in the LTAP group [P = 0.0031, 0.0037 and 0.00012, respectively]). LTAP was associated with a shorter hospital stay (P = 0.016) and less need for rescue analgesia (P = 0.031).
Conclusion: Laparoscopic transverse abdominis plane block is superior to port-site local anaesthesia infiltration in providing effective post-operative analgesia.
期刊介绍:
Journal of Minimal Access Surgery (JMAS), the official publication of Indian Association of Gastrointestinal Endo Surgeons, launched in early 2005. The JMAS, a quarterly publication, is the first English-language journal from India, as also from this part of the world, dedicated to Minimal Access Surgery. The JMAS boasts an outstanding editorial board comprising of Indian and international experts in the field.