Pain, Postoperative
Conditions
Brief summary
This study compares efficacy of transversus abdominis plane block and ilioinguinal nerve block for postoperative pain in patients undergoing inguinal herniorraphy with spinal anesthesia. One-third of the patients will receive standard postoperative pain regimen(control group), one-third will receive a transversus abdominis plane block (with ultrasound guidance) and the last group will receive an ilioinguinal nerve block(with ultrasound guidance) in addition to standard postoperative pain regimen. This study is a Randomized prospective open-label controlled study.
Interventions
PROCEDURESpinal Anesthesia
All patients will be administered 3ml of %0.5 bupivacaine through L3-L4 interspace to acquire motor and sensory blockade
PROCEDURETransversus Abdominis Plane Block
Analgesic intervention which will be performed only to Transversus Abdominis Plane Block arm. It requires 20ml of %0.25 bupivacaine administration through a 22 G. x 4 in. (100 mm) Insulated Echogenic Needle with 30° Bevel from midaxillary line between costal margin and anterior superior iliac spine with ultrasound guidance
PROCEDUREIlioinguinal Nerve Block
Analgesic intervention which will be performed only to Ilioinguinal Nerve Block arm. It requires 10ml of %0.25 bupivacaine administration through a 22 G. x 3-1/8 in. (80 mm) Insulated Echogenic Needle with 30° Bevel between umbilicus and iliac crest where the nerve is detected with ultrasound guidance
DEVICE25G Quincke needle
DEVICEEchogenic Needle with 30° bevel
DRUGAcetaminophen
Analgesic drug administration through iv and im route postoperatively. Patients are administered iv acetaminophen 1g twice a day routinely
DRUGTramadol
Patients will be administered tramadol in postoperative period when their pain score exceeds 4 points (moderate pain)
Sponsors
Bozyaka Training and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* patients over 18 years old * having ASA (American Society of Anesthesiologists) 1 or 2 physical status score preoperatively * not having a neuromuscular disease * scheduled for elective single sided inguinal herniorraphy operation
Exclusion criteria
* being under 18 years of age * patient refusal * having a neuromuscular disease or sensorial neurological deficit covering similar area of effect with peripheral nerve block interventions or the surgical site * having ASA 3 or 4 physical status score preoperatively * having one of the contraindications to spinal anesthesia and/or to peripheral nerve blocks as listed by NYSORA (New York School of Regional Anesthesia) * having emergency surgery or scheduled for bilateral inguinal herniorraphy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Pain Assessment with Verbal Descriptor Scale (VDS) | Baseline |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Complications (Assessment for existence of complications related to procedures in form of Y/N (such as hypotension, bradycardia, arrythmia, hematoma, failed block, nausea, vomiting, urinary retention, headache, back pain)) | Baseline | Assessment for existence of complications related to procedures (such as hypotension, bradycardia, arrythmia, hematoma, failed block, nausea, vomiting, urinary retention, headache, back pain) |
| First pain perception in postoperative period (The time when the patients experience pain perception after surgery for the first time) | whenever in 48 hours after surgery | The time when the patients experience pain perception after surgery for the first time |
| Additional analgesic requirements | Baseline | Assessment of additional analgesic requirements of patients defined as having a VDS (Verbal Descriptor Scale) greater than 4 (more intense than mild yet lower than moderate) |
Countries
Turkey (Türkiye)
Outcome results
None listed