Background: The rectus sheath block is a regional anesthetic technique that provides effective analgesia for midline abdominal surgeries. This study evaluated the feasibility of the rectus sheath block as the sole anesthetic technique for open umbilical hernia repair. Methods: A retrospective observational cohort study was conducted at a single secondary care hospital between 2017 and 2024. A total of 201 adult patients who had an elective open umbilical hernia repair with a pre-operative rectus sheath block were included. Patients were stratified into two groups with respect to their anesthetic plan: rectus sheath block only and rectus sheath block with general anesthesia. Primary outcomes were conversion rate to general anesthesia in the rectus sheath block group, post-anesthesia care unit recovery times, and postoperative pain scores. Data were analyzed using non-parametric tests under the intention-to-treat principle, and a two-sided P < 0.05 was considered statistically significant. Results: The conversion rate to general anesthesia was 1.19%. The rectus sheath block group had significantly shorter post-anesthesia care unit recovery times (26.67 ± 13.57 min vs. 49.64 ± 23.91 min; P < 0.001) and lower postoperative morphine milligram equivalent consumption (0.321 ± 1.513 mg vs. 2.955 ± 4.381 mg; P < 0.001) compared with the rectus sheath block with general anesthesia group. Postoperative pain scores were comparable between groups ( P = 0.170). Conclusion: The rectus sheath block is an effective sole anesthetic technique for open umbilical hernia repair, with a low conversion rate to general anesthesia.
Rispler et al. (Wed,) studied this question.
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