Comparative Effectiveness of Regional Anesthesia and Nerve Block Techniques in Reducing Chronic Post-Surgical Pain in Adults Undergoing Inguinal Hernia Surgery: A Systematic Review
Keywords:
Inguinal hernia, surgery, regional anesthesia, nerve block, Chronic post-surgical pain (CPSP)Abstract
Background: This study to show about comparative effectiveness of regional anesthesia and nerve block techniques in reducing chronic post-surgical pain in adults undergoing inguinal hernia surgery. Methods: By the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020, this study was able to show that it met all of the requirements. Result: Eight publications were found to be directly related to our ongoing systematic examination after a rigorous three-level screening approach. Subsequently, a comprehensive analysis of the complete text was conducted, and additional scrutiny was given to these articles. Conclusion: CPSP is a multifactorial and complex condition that can significantly affect the quality of life of patients undergoing surgery. General anesthesia plus ilioinguinal nerve block is better than spinal anesthesia (SA) regarding postoperative analgesia, time to mobilization and discharge, side-effect profile and satisfaction experienced by the patients. Regional block anesthesia (RBA) is superior to conventional spinal anesthesia (CSA) for pain relief at 24 hours post-surgery.
References
Fouad AZ, Abdel-Aal IRM, Ali Gadelrab MRM, El-Hadi Shoukat Mohammed HM. Ultrasound-guided transversalis fascia plane block versus transmuscular quadratus lumborum block for post-operative analgesia in inguinal hernia repair. Korean J Pain. 2021;34(2):201–9.
Chou R, Gordon DB, De Leon-Casasola OA, Rosenberg JM, Bickler S, Brennan T, et al. Management of postoperative pain: A clinical practice guideline from the American pain society, the American society of regional anesthesia and pain medicine, and the American society of anesthesiologists’ committee on regional anesthesia, executive committee, and administrative council. J Pain [Internet]. 2016;17(2):131–57. Available from: http://dx.doi.org/10.1016/j.jpain.2015.12.008
Grape S, Kirkham KR, Albrecht E. The analgesic efficacy of transversus abdominis plane block vs. wound infiltration after inguinal and infra-umbilical hernia repairs A systematic review and meta-analysis with trial sequential analysis. Eur J Anaesthesiol. 2022;39(7):611–8.
Fuller AM, Bharde S, Sikandar S. The mechanisms and management of persistent postsurgical pain. Front Pain Res [Internet]. 2023;4(July). Available from: https://doi.org/10.3389/fpain.2023.1154597
Werner MU, Kongsgaard UE. Defining persistent post-surgical pain: Is an update required? Br J Anaesth [Internet]. 2014;113(1):1–4. Available from: http://dx.doi.org/10.1093/bja/aeu012
Braun AS, Wakefield JD, Kukreja P, Simmons J, Ohlman B, Corey B, et al. Peripheral Nerve Blockade for Open Inguinal Hernia Repair in a Patient With Severe Cardiopulmonary Disease. Cureus. 2024;16(3):3–9.
Chen YYK, Boden KA, Schreiber KL. The role of regional anaesthesia and multimodal analgesia in the prevention of chronic postoperative pain: a narrative review. Anaesthesia. 2021;76(S1):8–17.
Kim BR, Yoon SH, Lee HJ. Practical strategies for the prevention and management of chronic postsurgical pain. Korean J Pain. 2023;36(2):149–62.
ONUR T, KARACA Ü, ÖKMEN K, TERKANLIOĞLU S, ONUR A. The effects of ilioinguinal nerve block on acute and chronic neuropathic pain in patients following inguinal hernia repair with spinal anesthesia: A prospective cohort study. J Surg Med. 2022;6(2):120–4.
Takebayashi K, Matsumura M, Kawai Y, Hoashi T, Katsura N, Fukuda S, et al. Efficacy of transversus abdominis plane block and rectus sheath block in laparoscopic inguinal hernia surgery. Int Surg. 2015;100(4):666–71.
Demirci A, Efe EM, Türker G, Gurbet A, Kaya FN, Anil A, et al. Iliohypogastric/ilioinguinal nerve block in inguinal hernia repair for postoperative pain management: comparison of the anatomical landmark and ultrasound guided techniques. Brazilian J Anesthesiol (English Ed. 2014;64(5):350–6.
Steffel L, Kim TE, Howard SK, Ly DP, Kou A, King R, et al. Comparative Effectiveness of Two Ultrasound-Guided Regional Block Techniques for Surgical Anesthesia in Open Unilateral Inguinal Hernia Repair. J Ultrasound Med. 2016;35(1):177–82.
Çelik HK, Tulgar S, Bük ÖF, Koç K, Ünal M, Genç C, et al. Comparison of the analgesic efficacy of the ultrasound-guided transversalis fascia plane block and erector spinae plane block in patients undergoing open inguinal hernia repair under spinal anesthesia. Korean J Anesthesiol. 2024;77(2):255–64.
Okur O, Tekgul ZT, Erkan N. Comparison of efficacy of transversus abdominis plane block and iliohypogastric/ilioinguinal nerve block for postoperative pain management in patients undergoing inguinal herniorrhaphy with spinal anesthesia: a prospective randomized controlled open-label study. J Anesth. 2017;31(5):678–85.
Tulgar S, Selvi O, Senturk O, Serifsoy TE, Thomas DT. Ultrasound-guided Erector Spinae Plane Block: Indications, Complications, and Effects on Acute and Chronic Pain Based on a Single-center Experience. Cureus. 2019;11(1):1–15.
Vizcaíno-Martínez L, Gómez-Ríos M, López-Calviño B. General anesthesia plus ilioinguinal nerve block versus spinal anesthesia for ambulatory inguinal herniorrhapy. Saudi J Anaesth. 2014;8(4):523–8.
Pedersen KF, Krpata DM, Rosen MJ, Bisgaard T. Laparoscopic treatment of chronic pain following inguinal hernia repair: a narrative review of the literature. Laparosc Surg. 2021;5(3):1–10.
Jain Y, Gianchandani Gyani SG, Chauhan S, Nayak K, Jain Y, Malhotra G, et al. Comparative Analysis of Bilateral Open Inguinal Hernia Repair and Rives-Stoppa Repair: A Comprehensive Review. Cureus. 2024;16(4):1–9.
Cheung CK, Adeola JO, Beutler SS, Urman RD. Postoperative Pain Management in Enhanced Recovery Pathways. J Pain Res. 2022;15:123–35.
Zwaans WAR, Koning GG, Gurusamy KS, van Kleef M, Scheltinga MRM, Roumen RMH. Surgical interventions for the management of chronic groin pain after hernia repair (postherniorrhaphy inguinodynia) in adults. Cochrane Database Syst Rev. 2017;2017(4).
Richebé P, Capdevila X, Rivat C. Persistent Postsurgical Pain. Anesthesiology [Internet]. 2018 Sep 1;129(3):590–607. Available from: https://pubs.asahq.org/anesthesiology/article/129/3/590/22257/Persistent-Postsurgical-PainPathophysiology-and
Uten T, Chesnais M, van de Velde M, Raeder J, Beloeil H. Pain management after open colorectal surgery. Eur J Anaesthesiol [Internet]. 2024 May;41(5):363–6. Available from: https://journals.lww.com/10.1097/EJA.0000000000001978
Lv J, Zhang Q, Zeng T, Li XF, Cui Y. Regional block anesthesia for adult patients with inguinal hernia repair: A systematic review. Med (United States). 2022;101(38):E30654.
Folino TB, Mahboobi SK. Regional Anesthetic Blocks [Internet]. StatPearls. 2024. Available from: http://www.ncbi.nlm.nih.gov/pubmed/31372836
Levene JL, Weinstein EJ, Cohen MS, Andreae DA, Chao JY, Johnson M, et al. Local anesthetics and regional anesthesia versus conventional analgesia for preventing persistent postoperative pain in adults and children: A Cochrane systematic review and meta-analysis update. J Clin Anesth. 2019;55:116–27.
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