Comparison of QLB and TFP Block for Postoperative Analgesia in Laparoscopic Inguinal Hernia
Comparison of the Effects of Ultrasound-Guided Lateral Quadratus Lumborum Block and Transversalis Fascia Plane Block on Postoperative Analgesia in Patients Undergoing Laparoscopic Inguinal Hernia Repair: A Randomized Controlled Trial
Studieöversikt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljerad beskrivning
Laparoscopic inguinal hernia repair is a standard, minimally invasive procedure. However, moderate pain is common in the first 24 hours postoperatively, originating from somatic pain at trocar sites and visceral pain from peritoneal irritation and mesh placement. Multimodal analgesia, including fascial plane blocks, is recommended to reduce opioid consumption and improve pain control.
In this prospective, randomized, controlled, single-center trial, 90 patients (ASA I-III, aged 18-65) scheduled for elective laparoscopic inguinal hernia repair under general anesthesia will be allocated into three parallel arms (n=30 each) via computer-based randomization.
Group QLB: Will receive bilateral ultrasound-guided lateral Quadratus Lumborum Block (total 40 mL 0.25% bupivacaine) prior to extubation, along with 10 mL 0.25% bupivacaine infiltration at port sites.
Group TFP: Will receive bilateral ultrasound-guided Transversalis Fascia Plane Block (total 40 mL 0.25% bupivacaine) prior to extubation, along with 10 mL 0.25% bupivacaine infiltration at port sites.
Group Control: Will receive only port site infiltration (total 20 mL 0.25% bupivacaine).
All procedures will be performed aseptically by the same surgical and anesthesia team. Postoperatively, all patients will receive 1 g intravenous paracetamol every 8 hours. Postoperative pain will be assessed using the Numeric Rating Scale (NRS) by an anesthesiologist blinded to the group allocation. Intravenous tramadol (100 mg) will be administered as rescue analgesia if the NRS score is ≥ 4. Total 24-hour tramadol consumption, along with block-related complications and opioid-related side effects (nausea, vomiting, sedation), will be recorded.
Studietyp
Studietyp
Inskrivning (Beräknad)
Inskrivning
Fas
Fas
- Inte tillämpbar
Kontakter och platser
Studieorter
-
-
-
Istanbul, Turkiet (Türkiye)
- Istanbul Medipol University
-
-
Deltagandekriterier
Urvalskriterier
Urvalskriterier
Åldrar som är berättigade till studier
- Vuxen
- Äldre vuxen
Tar emot friska volontärer
Beskrivning
Inclusion Criteria:
- Scheduled for elective laparoscopic inguinal hernia repair.
- American Society of Anesthesiologists (ASA) physical status I, II, or III.
- Age between 18 and 65 years.
- Provided written informed consent.
Exclusion Criteria:
- History of allergy to local anesthetics.
- Presence of coagulopathy.
- Signs of infection at the intended block application site.
- Body Mass Index (BMI) ≥ 35 kg/m².
- History of chronic opioid use.
- Presence of neurological disease.
- Refusal to participate in the study.
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Dubbel
Antal vapen
Vapen och interventioner
Deltagargrupp / ArmDeltagargrupp / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Experimentell: Group QLB
Patients will receive bilateral lateral Quadratus Lumborum Block (QLB) and port site infiltration at the end of the surgery.
|
Bilateral ultrasound-guided lateral QLB with 20 mL of 0.25% bupivacaine per side (total 40 mL).
Plus, 10 mL of 0.25% bupivacaine infiltration at trocar insertion sites.
|
|
Experimentell: Group TFP
Patients will receive bilateral Transversalis Fascia Plane (TFP) block and port site infiltration at the end of the surgery.
|
Bilateral ultrasound-guided TFP block with 20 mL of 0.25% bupivacaine per side (total 40 mL).
Plus, 10 mL of 0.25% bupivacaine infiltration at trocar insertion sites.
|
|
Aktiv komparator: Group Control
Patients will receive only port site infiltration at the end of the surgery.
|
Local infiltration of 20 mL of 0.25% bupivacaine at the trocar insertion sites.
|
Vad mäter studien?
Primära resultatmått
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Numeric Rating Scale (NRS) Pain Score
Tidsram: At 0, 3, 6, 12, 18, and 24 hours postoperatively.
|
Postoperative pain intensity assessed using the Numeric Rating Scale (NRS).
The scale ranges from 0 to 10, where 0 indicates "no pain" and 10 indicates "worst imaginable pain".
Higher scores represent worse pain outcomes.
|
At 0, 3, 6, 12, 18, and 24 hours postoperatively.
|
Sekundära resultatmått
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Total Tramadol Consumption
Tidsram: During the first 24 hours postoperatively.
|
The cumulative dose of intravenous tramadol (in milligrams) administered as rescue analgesia.
|
During the first 24 hours postoperatively.
|
|
Need for Rescue Analgesia
Tidsram: During the first 24 hours postoperatively
|
The number of patients requiring rescue analgesia (tramadol 100 mg IV) when the NRS score is ≥ 4.
|
During the first 24 hours postoperatively
|
|
Incidence of Opioid-Related Side Effects
Tidsram: During the first 24 hours postoperatively.
|
The number of patients experiencing postoperative nausea, vomiting, or sedation.
|
During the first 24 hours postoperatively.
|
|
Incidence of Block-Related Complications
Tidsram: During the first 24 hours postoperatively.
|
The number of patients experiencing complications related to the regional block application, such as hematoma, infection, or local anesthetic systemic toxicity (LAST).
|
During the first 24 hours postoperatively.
|
Samarbetspartners och utredare
Sponsor
Sponsor
Studieavstämningsdatum
Studera stora datum
Studiestart (Beräknad)
Studiestart
Primärt slutförande (Beräknad)
Primärt slutförande
Avslutad studie (Beräknad)
Avslutad studie
Studieregistreringsdatum
Först inskickad
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Först inskickad som uppfyllde QC-kriterierna
Första postat (Faktisk)
Första postat
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste uppdatering publicerad
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Senast verifierad
Mer information
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Ytterligare relevanta MeSH-villkor
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