Comparison of efficacy of Nalbuphine-Levobupivacaine combination with Levobupivacaine alone in ultrasound guided Transversus Abdominis Plane block in open inguinal hernia repair surgeries : A randomised control trial

Pain after open Hernia Repair surgeries can be moderate to severe and may be associated with prolonged hospital stay, increase in sympathetic activity leading to increase in heart rate, blood pressure, respiratory rate and even delirium. Transversus Abdominis Plane (TAP) Block is a recent modality used for postoperative analgesia with minimal side effects in Inguinal Hernia Repair surgeries. A local anaesthetic solution is deposited between the plane of Internal Oblique (IO) and Transversus Abdominis (TA) muscles. The  efficacy of Nalbuphine has been explored as an adjuvant to other drugs in central neuraxial blocks by epidural, caudal and intrathecal routes. But there is limited data of use of Nalbuphine in combination with Levobupivacaine in TAP block. So this study is planned to evaluate the analgesic efficacy of Nalbuphine with Levobupivacaine and Levobupivacaine alone in TAP block in hernia surgeries. The aim of the present study is to compare the analgesic efficacy of Nalbuphine with Levobupivacaine versus Levobupivacaine alone in  TAP block in Inguinal Repair Hernia surgeries. The objective is to assess the time of first rescue analgesic (duration of analgesia), to observe the visual analogue score (VAS)  (resting and ambulatory) for 24 hours, total number of analgesics required in 24 hours, to assess the haemodynamic parameters postoperatively and to observe the side effects.