ABSTRACT : To conduct inguinal hernia repair in a patient with dilated cardiomyopathy under usg guided tap block to attain haemodynamic stability with good patient satisfaction.

METHODS : The case was operated in routine surgery operation theatre of B.R.D medical college Gorakhpur. After taking written consent the patient was pre-medicated with 50 mcg of fentanyl, under full aseptic precaution in supine position usg guided tap block was given using 18 gauge Touhey needle and 25 ml of 0.375% bupivacain in right lumber triangle of petit’s.

RESULTS : Somatic pain was well controlled with local anaesthetic and i.v. fentanyl. Supplemental O2 was given to the patient additional fentanyl 25 mcg repeated in two doses one of which given at the time of spermatic cord handling. A satisfactory analgesia was achieved with good haemodynamic stability.

CONCLUSIONS : Though the tap block is mainly utilized for post operative analgesia as a part of multimodal analgesic regime, we could use it as a sole anaesthetic technique in conjunction with i.v. opioids for inguinal hernia repair in a patient with higher cardiovascular risk avoiding the complications of regional and general anaesthesia. Moreover usg guidance provides better accuracy, efficacy and safety.