Chamzin Alexandros, Frountzas Maximos, Gkiokas George, Kouskouni Evaggelia, Xanthos Theodoros, Michalopoulos Nikolaos V
First Department of Propaeudeutic Surgery, Medical School, National and Kapodistrian University of Athens, Hippocration General Hospital, Athens, Greece.
Department of Surgery, Medical School, National and Kapodistrian University of Athens, "Aretaieio" Hospital, Athens, Greece.
Front Surg. 2022 Feb 8;9:834050. doi: 10.3389/fsurg.2022.834050. eCollection 2022.
Managing postoperative pain even after laparoscopic groin hernia repair still remains an interesting challenge for clinicians especially for patients of high risk. Plenty of operative techniques and analgesic methods have been proposed in order to minimize postoperative pain after laparoscopic groin hernia repair. The aim of the present study is to compare transverse abdominis plane (TAP)-block with local analgesic infiltration at trocar entry sites in the terms of reducing postoperative pain.
Patients that underwent laparoscopic trans-abdominal pre-peritoneal (TAPP) groin hernia repair in a high-volume university hospital were included. Patients were divided in two groups depending on the analgesic method used. Pain was assessed using Visual Numerical Scale (VNS) score.
Thirty patients were included. Intraoperative TAP-block seemed to be superior in terms of decreasing pain at the hernia area and at the trocar insertion site ( < 0.05) compared to local analgesic infiltration at the trocar insertion site at 6, 12 and 24 h after surgery ( < 0.05). In addition, pain reduction was more effective in rest rather than in motion for both analgesic methods.
Intraoperative TAP-block under direct vision seems to be an effective, fast and easy technique in order to reduce postoperative pain after laparoscopic groin hernia repair, but more studies are required to validate these results in a prospective and randomized context.
即使在腹腔镜腹股沟疝修补术后，管理术后疼痛对于临床医生来说仍然是一项具有挑战性的任务，尤其是对于高危患者。为了尽量减少腹腔镜腹股沟疝修补术后的疼痛，人们提出了许多手术技术和镇痛方法。本研究的目的是比较腹横肌平面（TAP）阻滞与套管针穿刺部位局部镇痛浸润在减轻术后疼痛方面的效果。
纳入在一家大型大学医院接受腹腔镜经腹腹膜前（TAPP）腹股沟疝修补术的患者。根据所使用的镇痛方法将患者分为两组。使用视觉数字评分（VNS）量表评估疼痛。
共纳入30例患者。与术后6、12和24小时在套管针穿刺部位进行局部镇痛浸润相比，术中TAP阻滞在减轻疝区和套管针穿刺部位的疼痛方面似乎更具优势（P<0.05）。此外，两种镇痛方法在休息时的疼痛减轻效果均比活动时更有效。
直视下术中TAP阻滞似乎是一种有效、快速且简便的技术，可减轻腹腔镜腹股沟疝修补术后的疼痛，但需要更多研究在前瞻性随机研究中验证这些结果。
