{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T21:55:05Z","timestamp":1781646905280,"version":"3.54.5"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100017218","name":"Giresun University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100017218","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Hernia"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Selecting an optimal anesthetic technique for inguinal hernia repair is particularly challenging in patients with severe cardiac comorbidities and ongoing anticoagulant therapy. General anesthesia may increase cardiopulmonary instability, whereas neuraxial techniques carry risks of hypotension and bleeding complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We report the case of a 76-year-old man with advanced heart failure (ejection fraction 20%), New York Heart Association (NYHA) class III symptoms, pacemaker dependency, and chronic warfarin therapy who underwent elective open right inguinal hernia repair. Ultrasound-guided unilateral transversalis fascia plane (TFP) block (30 mL of 0.25% bupivacaine) combined with a transversus abdominis plane (TAP) block (20 mL of 0.25% bupivacaine) was performed as the sole anesthetic technique. Adequate sensory blockade over T12\u2013L1 dermatomes was achieved within 20 minutes. Surgery using the Lichtenstein technique was completed in 45 minutes with stable hemodynamic parameters, without the need for conversion to general anesthesia, surgical infiltration, or intraoperative opioid supplementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Postoperative pain was well controlled with multimodal non-opioid analgesia, with numerical rating scale (NRS) scores \u22642 during the first 24 hours. No rescue opioid analgesia was required. The patient had an uneventful recovery and was discharged on postoperative day 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The combination of transversalis fascia plane and TAP blocks may represent a feasible and effective anesthetic alternative for open inguinal hernia repair in carefully selected high-risk cardiac patients in whom general or neuraxial anesthesia is undesirable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10029-026-03628-4","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T11:12:39Z","timestamp":1774955559000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Open inguinal hernia repair under combined transversalis fascia plane and transversus abdominis plane blocks in a high-risk cardiac patient"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8757-1046","authenticated-orcid":false,"given":"Ilke","family":"Tamdogan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"3628_CR1","doi-asserted-by":"publisher","first-page":"8284363","DOI":"10.1155\/2017\/8284363","volume":"2017","author":"HC Tsai","year":"2017","unstructured":"Tsai HC, Yoshida T, Chuang TY et al (2017) Transversus abdominis plane block: an updated review of anatomy and techniques. 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Rev Esp Anestesiol Reanim 63(9):498\u2013504. https:\/\/doi.org\/10.1016\/j.redar.2016.02.005","journal-title":"Rev Esp Anestesiol Reanim"},{"issue":"1","key":"3628_CR4","doi-asserted-by":"publisher","first-page":"13","DOI":"10.24875\/CIRU.24000008","volume":"93","author":"EO Ahiskalioglu","year":"2024","unstructured":"Ahiskalioglu EO, Celik EC, Firinci B et al (2024) The efficacy of transversalis fascia plane block in pediatric inguinal herniotomy: a randomized controlled study. Cir Cir 93(1):13\u201320. https:\/\/doi.org\/10.24875\/CIRU.24000008","journal-title":"Cir Cir"},{"key":"3628_CR5","doi-asserted-by":"publisher","first-page":"7161860","DOI":"10.1155\/2018\/7161860","volume":"2018","author":"CL La Colla","year":"2018","unstructured":"La Colla CL, Schroeder MDL, Schroeder R (2018) Quadratus lumborum block as sole, homeostatic-preserving anesthetic for a patient with multiple system atrophy undergoing open inguinal hernia repair: a case report. 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Anaesthesia 56(10):1024\u20131026. https:\/\/doi.org\/10.1046\/j.1365-2044.2001.02279-40","journal-title":"Anaesthesia"},{"issue":"8","key":"3628_CR8","doi-asserted-by":"publisher","first-page":"618","DOI":"10.1007\/s12630-009-9110-1","volume":"56","author":"PD Hebbard","year":"2009","unstructured":"Hebbard PD (2009) Transversalis fascia plane block, a novel ultrasound-guided abdominal wall nerve block. Can J Anaesth 56(8):618\u2013620. https:\/\/doi.org\/10.1007\/s12630-009-9110-1","journal-title":"Can J Anaesth"},{"issue":"8","key":"3628_CR9","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1213\/XAA.0000000000000666","volume":"10","author":"P Scimia","year":"2018","unstructured":"Scimia P, Basso Ricci E, Petrucci E, Behr AU, Marinangeli F, Fusco P (2018) Ultrasound-guided transversalis fascia plane block: an alternative approach for anesthesia in inguinal herniorrhaphy: a case report. 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Written informed consent for publication was obtained from the patient.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Research registration number"}},{"value":"The authors have no conflict of interest.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"150"}}