Comparison of laparoscopic-guided transversus abdominis plane block and port-site local anaesthetic infiltration for post-operative pain relief in transabdominal preperitoneal inguinal hernia repair: A randomised controlled trial

INTRODUCTION: Inguinal hernia repair is a common surgical procedure, and effective post-operative pain management is crucial for patient recovery. This study compares the efficacy of laparoscopic-guided transversus abdominis plane (LTAP) block and port-site local anaesthetic infiltration (PSLAI) in post-operative pain relief after laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair. This study was done to evaluate the effectiveness of LTAP versus PSLAI in controlling post-operative pain, reducing hospital stay duration and accelerating recovery following TAPP inguinal hernia repair. PATIENTS AND METHODS: A randomised controlled trial was conducted with 60 patients, divided into two groups: LTAP and PSLAI. Pain levels were measured using the Visual Analogue Scale at 6, 12, 24 h and at discharge. The need for rescue analgesia, hospital stay duration and time to return to normal activities were also assessed. RESULTS: The LTAP group showed significantly lower pain scores at all post-operative time points compared to the PSLAI group (P values from 0.0017 to 0.0154). In addition, the LTAP group had a significantly shorter hospital stay (P = 0.0002) and quicker return to daily activities (P = 0.002). The need for rescue analgesia was significantly lower in the LTAP group (P = 0.043). CONCLUSION: LTAP block provided superior pain relief, reduced hospital stays and facilitated faster recovery compared to PSLAI. This technique should be considered for enhanced post-operative management following TAPP inguinal hernia repair.