PERIOPERATIVE PAIN MANAGEMENT IN PATIENTS WITH PERIPHERAL DENERVATION SYNDROME: AN EXAMPLE OF INGUINAL HERNIAS

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.

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