Authors
Baleev M.S.
City Clinical Hospital №7 named after E.L. Berezov, Nizhny Novgorod
Abstract
Background. The problem of postoperative pain management is a priority in modern surgery. At least 30% of patients suffer from severe pain in the early postoperative period, which worsens their psychoemotional state and complicates early resuscitation and rehabilitation. Physical inactivity, in turn, is a cause of postoperative complications, prolonged hospital stays, and increased treatment costs.
Objective. To evaluate the effectiveness of existing and newly proposed methods of pain relief in patients undergoing transabdominal preperitoneal grafting (TAPP).
Material and methods. A total of 160 patients with inguinal hernias were surgically treated using the TAPP technique. The patients were divided into 4 groups: the first (n = 40) – postoperative pain relief was performed according to the generally accepted scheme: intramuscular administration of non-steroidal anti-inflammatory drugs (NSAIDs); the second (n = 40) – pain relief was achieved using the transverse plane of the abdomen block (Transversus Abdominis Plane, TAP block); the third (n = 40) – block of the ilioinguinal and iliohypogastric nerves (IIN block); the fourth (n = 40) – a new method of intraoperative precision blockade of the nerves of the inguinal region (patent No. 2836327 dated March 12, 2025). The severity of the pain syndrome was assessed using a visual analogue scale (VAS).
Results. It was established that a new method of intraoperative precision blockade of the inguinal nerves in the form of a single injection of 7.5% ropivacaine anesthetic in a volume of 10 ml. during TAPP plasty of the inguinal canal, allows for a reduction in postoperative pain by 98% compared to other types of pain relief.
Conclusion. It has been established that the proposed technique of intraoperative precision blockade of the nerves of the inguinal region is a more effective and safe method of pain relief in patients undergoing laparoscopic plastic surgery of the inguinal canal.
Keywords: inguinal hernia, denervation syndrome, perioperative pain, pain syndrome, blockade.
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