{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:42:36Z","timestamp":1792190556205,"version":"4.4.0"},"reference-count":22,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2024,6,28]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>A bilateral oblique subcostal transverse abdominis plane block may help provide perioperative analgesia and reduce opioid use in patients undergoing sublay mesh hernia repair, but its clinical value is unclear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In a single-centre, prospective, placebo-controlled, double-blind study, patients scheduled for sublay mesh hernia repair were randomized to receive oblique subcostal transverse abdominis plane blocks with either 60 ml of 0.375% ropivacaine (n=19) or isotonic saline (placebo, n=17). The primary outcome was patient-controlled total morphine consumption at 8:00 p.m. on the second postoperative day (POD), while secondary outcomes included the total morphine consumption during the post-anesthesia care unit stay and the occurrence of adverse events.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Total morphine consumption at 8:00 p.m. on the second POD was higher in patients receiving ropivacaine (39 mg, IQR 22, 62) compared with placebo (24 mg, IQR 7, 39), p value = 0.04. In contrast, the ropivacaine group received 2 mg less morphine during the post-anesthesia care unit stay (4 mg, IQR: 4, 9 mg vs 2 mg, IQR: 2,6 mg, p = 0.04). Patients receiving ropivacaine used more morphine (8:00 p.m. on the first POD until 8:00 a.m. on the second POD: 8 mg, IQR: 4, 18 mg vs 2 mg, IQR: 0, 9 mg, p = 0.01) and reported higher maximum pain scores since the last assessment (8:00 a.m. on the second POD: 5, IQR: 4, 7 vs 4, IQR: 3, 5, p = 0.03). There were no differences in adverse events between groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Bilateral oblique subcostal transverse abdominis plane blocks in patients undergoing sublay mesh hernia repair were not associated with a prolonged reduction in patient-controlled total morphine consumption in the evening of the second POD in this study. Rebound pain might explain the additional excess opioid required by the ropivacaine group.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rapm-2024-105596","type":"journal-article","created":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T20:10:38Z","timestamp":1720469438000},"page":"786-793","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Oblique subcostal transverse abdominis plane block for postoperative pain control in patients undergoing open sublay mesh hernia repair: a prospective double-blind randomized placebo-controlled clinical trial"],"prefix":"10.1136","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5810-8845","authenticated-orcid":false,"given":"Marius","family":"Keller","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Eberhard Karls Universit\u00e4t T\u00fcbingen, T\u00fcbingen, Baden-W\u00fcrttemberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friederike","family":"Dinkel","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Medicine, Diakonie-Klinikum Stuttgart, Stuttgart, Germany"},{"name":"School of Medicine, Eberhard Karls Universit\u00e4t T\u00fcbingen, T\u00fcbingen, Baden-W\u00fcrttemberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johann","family":"Jacoby","sequence":"additional","affiliation":[{"name":"Institute for Clinical Epidemiology and Applied Biometry, Eberhard Karls Universit\u00e4t T\u00fcbingen, T\u00fcbingen, Baden-W\u00fcrttemberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Kraft","sequence":"additional","affiliation":[{"name":"Department of General and Visceral Surgery, Diakonie-Klinikum Stuttgart, Stuttgart, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Haas","sequence":"additional","affiliation":[{"name":"Dispensary, Diakonie-Klinikum Stuttgart, Stuttgart, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Rosenberger","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, Eberhard Karls Universit\u00e4t T\u00fcbingen, T\u00fcbingen, Baden-W\u00fcrttemberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rainer","family":"Meierhenrich","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Medicine, Diakonie-Klinikum Stuttgart, Stuttgart, 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