{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T04:07:29Z","timestamp":1792382849999,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Inguinal hernia repair is one of the most common surgical procedures worldwide and is frequently performed as day\u2010case surgery. Postoperative pain may delay recovery and occasionally necessitate unplanned hospital admission. Regional anesthesia techniques, including transversus abdominis plane (TAP) and rectus sheath (RS) blocks, have shown promise in improving analgesia. However, their combined efficacy in open inguinal hernia repair has not been established in randomized trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The PRO\u2010RSTAP trial is a prospective, double\u2010blind, four\u2010arm randomized controlled trial conducted at three hospitals in Finland. The study evaluates the individual and combined effects of TAP and RS blocks in adults undergoing elective open inguinal hernia repair. Two hundred patients are randomized equally into four groups: (1) placebo TAP\u2009+\u2009placebo RS, (2) active TAP\u2009+\u2009placebo RS, (3) active RS\u2009+\u2009placebo TAP, and (4) active TAP\u2009+\u2009active RS. All patients receive standardized sedation and multimodal analgesia, including paracetamol, nonsteroidal anti\u2010inflammatory drugs (NSAIDs), and rescue opioids. The primary outcome is cumulative perioperative opioid consumption from block administration until hospital discharge, expressed as intravenous morphine equivalents. Secondary outcomes include pain scores, conversion to general anesthesia, postoperative nausea and vomiting, time to discharge, and unplanned admissions or emergency visits within 7\u2009days. The planned sample size provides 80% power to detect a clinically meaningful reduction in opioid use (two\u2010sided\n                      <jats:italic>\u03b1<\/jats:italic>\n                      \u2009=\u20090.05). Analyses follow the intention\u2010to\u2010treat principle.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The first participant was enrolled in September 2025, and the trial is ongoing. No interim efficacy analysis is planned. Safety is monitored continuously throughout the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This randomized controlled trial is designed to determine whether combining TAP and RS blocks improves postoperative analgesia and recovery after open inguinal hernia repair. The results will contribute to evidence\u2010based optimization of regional anesthesia strategies in ambulatory surgery.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      EU Clinical Trials Information System (CTIS): 2024\u2010513406\u201059\u201000;\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      identifier: NCT07423910\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aas.70238","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T08:56:14Z","timestamp":1778057774000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Combined Transversus Abdominis Plane and Rectus Sheath Blocks in Open Inguinal Hernia Repair: Protocol for a Double\u2010Blind Randomized Controlled Trial (\n                    <scp>PRO<\/scp>\n                    \u2010\n                    <scp>RSTAP<\/scp>\n                    )"],"prefix":"10.1111","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7963-4963","authenticated-orcid":false,"given":"Pia","family":"Nordstr\u00f6m","sequence":"first","affiliation":[{"name":"Division of Surgery, Gastroenterology and Oncology Tampere University Hospital, Pirkanmaa Wellbeing Services County  Tampere Finland"},{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aki","family":"Lumme","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"},{"name":"Department of Anesthesia Tampere University Hospital, Pirkanmaa Wellbeing Services County  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juha","family":"Virman","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"},{"name":"Department of Anesthesia Tampere University Hospital, Pirkanmaa Wellbeing Services County  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6501-8928","authenticated-orcid":false,"given":"Maija\u2010Liisa","family":"Kalliom\u00e4ki","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology Tampere University  Tampere Finland"},{"name":"Department of Anesthesia Tampere University Hospital, Pirkanmaa Wellbeing Services County  Tampere Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,6]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)14746-0"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004735"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14639"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2044.2002.2366_2.x"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30352-6"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0000000000000319"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313481808401134"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002169"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-005-0203-9"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2009.06203.x"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000412"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000015159"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000001014"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0000000000001552"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000002376"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000005762"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000001464"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000001873"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000017545"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.9738\/INTSURG-D-14-00193.1"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.2217\/pmt-2015-0012"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/wjs.12481"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2017.06.017"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003134820942179"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2019.05.012"}],"container-title":["Acta Anaesthesiologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aas.70238","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aas.70238","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aas.70238","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T01:14:31Z","timestamp":1785374071000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aas.70238"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,6]]},"references-count":25,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/aas.70238"],"URL":"https:\/\/doi.org\/10.1111\/aas.70238","archive":["Portico"],"relation":{},"ISSN":["0001-5172","1399-6576"],"issn-type":[{"value":"0001-5172","type":"print"},{"value":"1399-6576","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,6]]},"assertion":[{"value":"2026-02-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70238"}}