Inguinal Hernias
Conditions
Keywords
Bupivacaine Hydrochloride, Spinal Anesthesia, Nerve Blocks, Iliohypogastric Nerve Neuralgia, Ilioinguinal Neuralgia, Adults, Lidocaine Hydrochloride, Normal Saline, Sulfentanyl
Brief summary
Postoperative pain management remains a critical area of concern in surgical practices, especially in procedures involving the lower abdomen and pelvis. Inguinal Hernia is considered among few surgeries that may lead to chronic pain. Spinal anesthesia is a commonly utilized modality because of its efficacy in pain control and rapid recovery. However, the addition of peripheral nerve blocks, such as the ilioinguinal nerve block, may provide enhanced pain relief and reduce opioid consumption postoperatively. This study aims to evaluate the effectiveness of spinal anesthesia alone compared to spinal anesthesia supplemented with ultrasound-guided ilioinguinal and iliohypo-gastric nerve block in managing postoperative pain.
Detailed description
Objectives 1. Primary Objective: To compare the postoperative pain scores (using a standardized numerical rating scale) between patients receiving spinal anesthesia alone and those receiving spinal anesthesia with ultrasound-guided ilioinguinal nerve block. 2. Secondary Objectives: * To assess the total opioid consumption in the first 24 hours post-surgery. * To evaluate the time to first analgesic request postoperatively. * Patient Satisfaction score post-op \>\> at rest , coughing , ambulation ( LEKENT SCORE ) . Hypotheses * Hypothesis 1: Patients receiving spinal anesthesia with an ilioinguinal nerve block will experience significantly lower postoperative pain scores compared to those receiving spinal anesthesia alone. * Hypothesis 2: Patients receiving spinal anesthesia with an ilioinguinal nerve block will require less opioid medication in the first 24 hours post-surgery.
Interventions
15cc 0.25% of Bupivacaine + Dexamethasone 8 mg 2cc
OTHERIlioinguinal/iliohypogastric with Placebo Block
17 cc of Placebo
Sponsors
Makassed General Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
DOUBLE (Subject, Caregiver)
Intervention model description
This study will be a randomized prospective , double-blind, controlled trial conducted in a tertiary care surgical unit. A total of 100 patients (50 in each group) undergoing lower Inguinal hernia surgery will be enrolled based on power analysis. Anesthetic Technique * Group A: Spinal anesthesia will be administered using a standard technique with a 25G spinal needle, targeting the appropriate vertebral level. * Group B: In addition to spinal anesthesia, an ultrasound-guided ilioinguinal nerve block will be performed post to the surgical incision.
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* Adults aged 18-65 years * ASA physical status I-III * Scheduled for elective lower abdominal surgery (e.g., inguinal hernia repair, cesarean section)
Exclusion criteria
* Allergy to local anesthetics * Coagulation disorders * Infection at the injection site * Patients with neurological conditions affecting lower limbs
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative pain management | 24 hours | Pain scores will be assessed using an 11-point numerical rating scale (0-10) at 1, 6, 12, and 24 hours postoperatively. |
Countries
Lebanon
Outcome results
None listed