Journal of Anaesthesia and Pain
Vol 4, No 1 (2023): January

Ultrasound-guided Transversus Abdominis Plane Block for Postoperative Analgesia in Patient Undergoing Inguinal Hernia Repair

Heri Dwi Purnomo (Department of Anestesiology and Intensive Therapy, Sebelas Maret University, Dr. Moewardi General Hospital, Surakarta)
Dimas Yuliar Sevanto (Department of Anestesiology and Intensive Therapy, Sebelas Maret University, Dr. Moewardi General Hospital, Surakarta)



Article Info

Publish Date
31 Jan 2023

Abstract

Background: The Transversus Abdominis Plane (TAP) block technique is one method for inhibiting abdominal pain stimuli by blocking afferent nerves in the abdominal wall via the Petit triangle. TAP block action is frequently performed as a postoperative procedure, such as in the case of hernia repair. The goal of using ultrasound in TAP blocks is to distribute the anesthetic agent accurately in the appropriate neurovascular plane.Case: A 66-year-old male geriatric patient with an incarcerated right inguinal hernia and a history of Hypertensive Heart Disease (HHD) was seen. The patient complained of right groin pain that spread to the right side of the abdomen. Based on the Electrocardiogram (ECG), atrial fibrillation was identified as slow ventricular response and Left Ventricular Hypertrophy (LVH). Chest X-ray revealed cardiomegaly with LVH configuration. ASA III E was assigned to the patient. Regional Anesthesia Subarachnoid Block (RASAB) was used to perform an emergency hernia repair using a regimen of Bupivacaine heavy 0.5% 7.5 mg with adjuvant Fentanyl 50 g. Bilateral TAP block administration using Ropivacaine regimen 0.25% of the total volume of 30 ml was given as postoperative analgesia management. Hemodynamic monitoring, complications and postoperative pain scale were carried out in the High Care Unit (HCU). Hemodynamically stable, pain scale was 1-2 at 24 hours postoperative and no complications. Conclusion: TAP block is provide an effective and safe anti-pain effect in patients undergoing hernia repair with geriatric comorbidities and a history of HHD, as well as to prevent cardiovascular complications and to speed up postoperative patient mobilization.

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Journal Info

Abbrev

jap

Publisher

Subject

Health Professions Medicine & Pharmacology

Description

Journal of Anaesthesia and Pain is a peer-reviewed and open-access journal that focuses on anesthesia and pain. Journal of Anaesthesia and Pain, published by Anesthesiology and Intensive Therapy Specialist Program of Medicine Faculty, Brawijaya University. This journal publishes original articles, ...