Table of Contents

2017 Month : June Volume : 3 Issue : 1 Page : 6-10

A STUDY TO ASSESS THE USEFULNESS OF TRANSVERSUS ABDOMINIS PLANE BLOCK AS SOLE ANAESTHETIC FOR DAY CASE BILATERAL HERNIA SURGERY ALONG WITH DEXMEDETOMIDINE INFUSION AND LOCAL INFILTRATION.

Sivakumar R. Pillai1, Keerthy S2, Suresh Babu3

Corresponding Author:
Dr. Sivakumar R,
Pillai, Vasanth, Ekra 38,
Kariyam, Powdikonam,
Trivandrum-695588, Kerala,
India.
E-mail: ssivapillai75@gmail.com

ABSTRACT

BACKGROUND

Hernia surgeries are usually done as day case without the need for admission to hospital. Several anaesthesia techniques are used like general anaesthesia, spinal anaesthesia, local infiltration, etc. Here we used combinations of TAP block and sedation to do the surgeries with good operating conditions.

Aim- To study the usefulness of TAP block as a sole anaesthetic technique for day case hernia surgery along with dexmedetomidine infusion.

Materials and Methods

Settings and design- Sree Gokulam Medical College and Research Institute, Venjaramoodu, Thiruvananthapuram, Kerala, India for a period of one year from 1st May 2015 to 31st April 2016.

45 ASA I-II patients were subjected to hernia surgery under TAP block using USG with 20 mL of Sensorcaine 0.25% along with fentanyl bolus 100 mcg and dexmedetomidine infusion of 0.5 mcg/kg/hour following bolus of 1 mcg/kg till the end of the surgery. USG was used to perform all the blocks. Only the blocks that were effective were included. The rest were converted to GA and excluded from the study. Patient’s vitals were monitored and pain was assessed postoperatively using VAS scale. Rescue analgesia was given when the VAS scale was >4 using paracetamol or tramadol. Patients were discharged after eight hours once they have voided.

Statistical analysis- Statistical analysis was done using Microsoft Excel. Mean score and standard deviation were calculated. Proportion and percentages were calculated for categorical variables.

Results

TAP block is useful as an anaesthetic technique for day case hernia surgery.1 Dexmedetomidine bolus and infusion helps to improve patient comfort and suppresses the visceral component of pain during herniorrhaphy.

Conclusion

Hernia surgeries can be safely done using TAP plane block and sedation. The advantage of long duration of analgesia gives patient the comfort of early discharge and less need for supplemental opioids. Absence of motor block is also advantageous with early mobilisation and voiding.

KEYWORDS

Transversus Abdominis, Hernia, Local Anaesthetic, Dexmedetomidine, Visual Analogue Scale, Petit Triangle.

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