PDF(Pubmed)
Abstract：
Background and objective The role of the pre-peritoneal infiltration of local anesthetic (PILA) in laparoscopic hernia repair has been equivocal. Ultrasound-guided transversus abdominis plane (TAP) block has been extensively studied. However, studies comparing these two methods are very scarce. Hence, this study was undertaken to compare the efficacy of pre-peritoneal plus portal infiltration with TAP block in this population. Materials and methods This double-blinded randomized comparative study was conducted on a total of 32 patients by allotting 16 patients in each group. Group A patients were given pre-peritoneal plus portal infiltration of 15 mL of 0.5% ropivacaine for each technique by the operating surgeon, while Group B patients were administered bilateral TAP block with 0.5% ropivacaine, 15 mL on each side under ultrasound guidance by the anesthesiologist. Results The demographic variables and duration of surgery were comparable between the two groups. Also, the postoperative requirement of fentanyl between the two groups was insignificant. However, the duration of anesthesia was significantly longer in Group B attributing to the extra time taken for the administration of the TAP blocks. Conclusion Both ultrasound-guided TAP block and the PILA plus portal infiltration are effective techniques for pain relief after laparoscopic hernia repair. Either of these two techniques can be chosen depending on the availability of resources, expertise, etc.
摘要：
背景与目的局部麻醉药（PILA）腹膜前浸润在腹腔镜疝修补术中的作用一直不明确。超声引导下腹横肌平面（TAP）阻滞已被广泛研究。然而,比较这两种方法的研究非常缺乏。因此，本研究旨在比较该人群中腹膜前加门静脉浸润与TAP阻滞的疗效.材料和方法通过分配每组16名患者,对总共32名患者进行双盲随机比较研究。A组患者由手术外科医生对每种技术给予15mL的0.5％罗哌卡因腹膜前加门静脉浸润，而B组患者使用0.5%罗哌卡因进行双侧TAP阻滞,在麻醉师的超声引导下每侧15mL。结果两组的人口统计学变量和手术时间具有可比性。此外，两组患者术后对芬太尼的需求不显著.然而,B组的麻醉持续时间显著延长,这归因于TAP阻滞给药所需的额外时间.结论超声引导下TAP阻滞和PILA联合门静脉浸润是缓解腹腔镜疝修补术后疼痛的有效方法。可以根据资源的可用性选择这两种技术中的任何一种，专业知识,等。
