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Reduction of opioid use using regional anesthetic blocks after inguinal hernia repair in a high risk, safety net population

Sayeeda Rab, BS, Sudeepti Vedula, BS, Aziz M. Merchant, MD, FACS


Objective: The transversus abdominis plane (TAP) block is currently being used perioperatively to reduce postoperative opioid requirements. It is unclear whether TAP blocks reduce postoperative opioid requirements for inguinal hernia repairs. The purpose of this retrospective chart study was to determine whether a TAP block reduces postoperative opioid requirements after an inguinal hernia repair in a safety net hospital.

Design: This was a retrospective chart review that evaluated patients at University Hospital in Newark, NJ, who had inguinal hernia repairs from January 2011 to July 2019. Patients were divided into two groups depending on whether they had a TAP block or not. The primary outcome was the amount of opioid required in the first 24 hours postoperatively by a patient reported as morphine equivalent dosing (MED).

Results: The group that received the TAP block had a mean (95 percent CI) MED of 7.01 mg (6.70, 7.33), and the control group (no TAP block) had a mean MED of 11.6 mg within 24 hours of the inguinal hernia (p = 0.03). There was no significant difference for postoperative visual analog scale (VAS) pain score, presence of nausea, or length of stay.

Conclusions: Patients with TAP block required less morphine equivalence of opioid within a 24 hours period after an inguinal hernia repair.


transversus abdominus block, visual analog scale, inguinal hernia repair, opioid epidemic, postoperative analgesia

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