A Comparative Study Of Efficacy And Safety Of Ultrasound-Guided Transversus Abdominis Plane (Tap) Block With Unilateral Spinal Anaesthesia For Inguinal Hernia Repair In Geriatric Patients

BACKGROUNDInguinal hernia repair, a commonly performed surgery in geriatric population is conducted under either general or regional anaesthesia. Post-operative pain in addition to poor cardiovascular and respiratory reserve in geriatric patients increases morbidity and length of hospital stay. Intravenous analgesics for postoperative pain produces various side effects. The unilateral spinal anaesthesia, which restricted the undesired sympathetic block is compared with ultrasound-guided (USG) transversus abdominis plane (TAP) block.MATERIALS AND METHODSForty adult male geriatric patients of more than 60 years of age of ASA Grade I and II were divided into two groups of 20 each. They were given either USG TAP block (Group T) or unilateral spinal anaesthesia (Group S) for inguinal hernia repair surgery. Time to perform block, peak of block, quality of motor block, rescue analgesia for postoperative pain and side effects were noted. Statistical analysis was done by paired and unpaired "t" test using SPSS version 16.0.RESULTSThe time needed to perform block and time to reach maximum level of sensory block was significantly greater in Group T. The time taken for first rescue analgesia was significantly greater in Group T. The quality of block was better in Group S. No side effects were observed in Group T, while one patient had bradycardia and two patients had hypotension in Group S.CONCLUSIONUnilateral spinal block provides better intra-operative block, while TAP block provides better postoperative analgesia with less haemodynamic disturbances and other side effects and may be used as sole anaesthetic technique in geriatric patients.