Postoperative Analgesia of Inguinal Hernia Repair in Adults
Conditions
Brief summary
The aim of our study is to investigate the effect of the ultrasound guided transversalis fascia plane block on the postoperative opioid consumption as a part of multimodal analgesia in patients undergoing inguinal herniorrhaphy under spinal anesthesia.
Detailed description
The aim of our study is to investigate the efficacy of the ultrasound-guided transversalis fascia plane block as a postoperative analgesia as a part of multimodal analgesia in patients undergoing inguinal herniorrhaphy under spinal anesthesia. The ultrasound (US)-guided transversalis fascia plane (TFP) block was first described by Hebbard in 2009. A local anesthetic (LA) injected between the transversus abdominis muscle, and its deep investing fascia will block the anterior and the lateral branches of the T12 and L1 nerves (4). The efficacy of this block has been demonstrated in iliac crest bone graft harvesting, caesarean section and inguinal herniorrhaphy
Interventions
DRUGbupivacaine injection by ultrasound guided transversalis fascia plane block
With patients in a sitting position and after appropriate skin asepsis, a 25-G pencil-point spinal needle (Pencil Point Spinal Needle Set, Egemen International Ltd., Izmir, Turkey) will be inserted through the L3 to L4 or L4 to L5 intervertebral space and 15 mg of 0.5% hyperbaric bupivacaine (AstraZeneca Pharmaceuticals, Cambridge, United Kingdom) will be injected. Subsequently, the patients will be positioned supine.
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Caregiver)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* Patients undergoing inguinal herniorrhaphy. * Patients 18-60 years. * ASA I and II. * Both sexes. * Having no contraindication for spinal anesthesia or TFP block.
Exclusion criteria
* Refusal of regional anesthesia. * Infection in the back or at the site of injection for TFP block. * INR \> 1.5. * Platelet count \< 80000 per microliter of blood. * Patients known to be allergic to amide local anesthetics. * BMI greater than 35 kgm\_2. * Opioid addiction. * Have communication problems that may hinder the assessement of pain postoperative.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The total amount of postoperative morphine consumption during the first 24hrs postoperative. | First 24 hours postoperative | The patients will be evaluated regarding the first demand to rescue analgesia postoperatively. The pain will be assessed by the VAS score. It will be performed in the immediate post-operative period every 15 min for the first 60 min, 2 h, 4 h, 8h, 12h, 18 and 24 h. Breakthrough pain will be defined as VAS \>4 at rest. |
Countries
Egypt
Contacts
Primary ContactRabab Sabry, MD
Backup ContactOmnia Kamel, MD
Outcome results
None listed