Efficacy of transversus abdominis plane block with ketamine for inguinal hernioplasty: A controlled study

Background Addition of ketamine to bupivacaine would improve the duration of analgesia after transversus abdominis plane ( TAP) block for inguinal hernioplasty. Materials and Methods After ethical approval, 28 patients scheduled for elective unilateral inguinal hernioplasty under sevoflurane-fentanyl-rocuronium anesthesia were randomly allocated to receive ipsilateral TAP block to the side of surgery with either bupivacaine 0.5% or bupivacaine 0.5% with 0.5 mg/kg ketamine (n = 14 for each). Postoperative 24 h cumulative morphine consumption, first request for morphine, pain scores at rest, sedation, nausea and vomiting scores, and complications were recorded. Results Patients who received TAP bupivacaine-ketamine had comparable postoperative 24 h cumulative morphine consumption, first request for morphine, pain and sedation scores, and postoperative nausea and vomiting. No patient reported postoperative complications related to ketamine. Conclusion The author is able to reject with confidence the hypothesis that the addition of ketamine to bupivacaine for TAP block has any major analgesic effect after inguinal hernioplasty.