Ultrasound-guided transversus abdominis plane block in patients undergoing open inguinal hernia repair: 0.125% bupivacaine provides similar analgesic effect compared to 0.25% bupivacaine

J Clin Anesth. 2016 Feb:28:41-6. doi: 10.1016/j.jclinane.2015.07.020. Epub 2015 Sep 9.

Abstract

Study objective: To evaluate the effectiveness of 0.125% bupivacaine compared to 0.25% bupivacaine for ultrasound-guided transversus abdominis plane (TAP) block in patients undergoing open inguinal hernia repair.

Design: Randomized, double-blind study.

Setting: Educational and research hospital.

Patients: Forty adult patients of American Society of Anesthesiologists physical status I-III undergoing elective primary unilateral open inguinal hernia repair under spinal anesthesia.

Interventions: Patients in group I received 20 mL of 0.25% bupivacaine, whereas patients in group II received 20 mL of 0.125% bupivacaine for TAP block at the end of the surgery.

Measurements: Pain intensity was assessed at rest and during coughing using 10-cm visual analog scale score at 5, 15, 30, and 45 minutes and 1, 2, 4, 6, 12, and 24 hours after TAP block. Morphine consumption and time to first morphine requirement were recorded.

Main results: Visual analog scale scores at rest and during coughing were not significantly different between groups at all time points measured. Twenty-four hours of morphine consumption (7.72±7.33 mg in group I and 6.06±5.20 mg in group II; P=.437) and time to first morphine requirement (182.35±125.16 minutes in group I and 143.21±87.28 minutes in group II; P=.332) were not different between groups.

Conclusions: 0.125% Bupivacaine provides similar analgesic effect compared to 0.25% bupivacaine for ultrasound-guided TAP block in patients undergoing open inguinal hernia repair.

Keywords: Bupivacaine; Open inguinal hernia repair; Postoperative analgesia; Transversus abdominis plane block.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Abdominal Muscles / diagnostic imaging*
  • Adult
  • Aged
  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / therapeutic use
  • Anesthesia, Spinal / methods
  • Anesthetics, Local* / administration & dosage
  • Bupivacaine* / administration & dosage
  • Double-Blind Method
  • Elective Surgical Procedures
  • Female
  • Hernia, Inguinal / surgery*
  • Herniorrhaphy / methods*
  • Humans
  • Male
  • Middle Aged
  • Morphine / administration & dosage
  • Morphine / therapeutic use
  • Nerve Block / methods*
  • Pain Measurement
  • Pain, Postoperative / drug therapy
  • Ultrasonography, Interventional / methods*

Substances

  • Analgesics, Opioid
  • Anesthetics, Local
  • Morphine
  • Bupivacaine