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A randomized clinical study on postoperative pain comparing between the supraglottic airway device and endotracheal tubing in transabdominal preperitoneal repair (TAPP)

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Abstract

Background

Transabdominal preperitoneal (TAPP) repair is the most widely used laparoscopic technique for the treatment of inguinal hernia in Japan. Many studies have shown that in comparison with open hernia repair, laparoscopic repair results in less pain and a shorter convalescence. However, postoperative pain remains a concern. One possible cause of postoperative pain in the early postoperative phase is strain or cough on removal of the endotracheal tube. Use of a supraglottic airway (SGA) device helps to avoid such complaints. We evaluated postoperative pain after TAPP repair using the SGA for general anesthesia.

Methods

We evaluated the postoperative pain in 146 patients with inguinal hernia repaired by TAPP in our hospital between May 2013 and May 2016. A total of 144 adult patients of American Society of Anesthesiologists physical status I and II who underwent needlescopic TAPP surgery were randomly allocated to one of two groups of 72 patients: group A (SGA), in which the patient’s airway was secured with an appropriately sized I-gel, and group B (endotracheal tube), in which the airway was secured under laryngoscopy.

Results

There was no significant difference between the groups regarding patient background, postoperative hospital stay, and operation time, and TAPP was performed safely in all cases. In the analysis of postoperative pain, the mean Numerical Rating Scale score of peak pain in group A was significantly less than that of group B (2.10 ± 2.05 vs 2.90 ± 2.65; p = 0.043). In group A, the percentage of patients who had an NRS score of 0 was 51.4% 30 min after surgery, 62.5% after 6 h and 68.1% at POD1, and compared to group B, the NRS scores were significantly higher at POD1 (p = 0.003), and the level of postoperative pain in group A tended to decrease earlier than that in group B.

Conclusions

The results of this study are the first to show that an SGA device can reduce postoperative pain after laparoscopic surgery.

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Acknowledgements

We are thankful to the Anesthesiology Department for their cooperation in this study.

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Authors and Affiliations

  1. Department of Surgery, Kurashiki Central Hospital, Miwa 1-1-1, Kurashiki City, Okayama, Japan

    Y. Nagahisa, K. Hashida, R. Matsumoto, R. Kawashima, M. Okabe & K. Kawamoto

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  1. Y. Nagahisa
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  2. K. Hashida
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  3. R. Matsumoto
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  4. R. Kawashima
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  5. M. Okabe
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  6. K. Kawamoto
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Corresponding author

Correspondence to Y. Nagahisa.

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Conflict of interest

YN, KH, RM, RK, MO and KK have no conflict of interest or financial disclosures.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Human and animal rights

This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Nagahisa, Y., Hashida, K., Matsumoto, R. et al. A randomized clinical study on postoperative pain comparing between the supraglottic airway device and endotracheal tubing in transabdominal preperitoneal repair (TAPP). Hernia 21, 391–396 (2017). https://doi.org/10.1007/s10029-017-1586-y

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  • DOI: https://doi.org/10.1007/s10029-017-1586-y

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