Transversus Abdominis Plane Block Versus Ilioinguinal Nerve Block for Pain Management in Inguinal Herniorraphy

Bozyaka Training and Research Hospital

Status: Completed

Conditions: Pain, Postoperative

Treatments: Drug: Acetaminophen; Procedure: Transversus Abdominis Plane Block; Device: Echogenic Needle with 30° bevel; Drug: Tramadol; Device: 25G Quincke needle; Drug: Bupivacaine %0.5 (hyperbaric); Procedure: Ilioinguinal Nerve Block; Drug: Bupivacaine %0.25 (isobaric); Procedure: Spinal Anesthesia

Study type: Interventional

Funder types: Other

Identifiers

NCT02375100

IzmirBoyaka

Details and patient eligibility

About

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.

Enrollment: 90 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

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

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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90 participants in 3 patient groups

Intrathecal bupivacaine&analgesics

Active Comparator group

Description:

Patients will be given standard care during perioperative period. They will undergo inguinal herniorraphy operation under spinal anesthesia (with 3ml of %0.5 hyperbaric bupivacaine intrathecally) and receive an parenteral pain regimen (acetaminophen for intravenous infusion in two doses routinely and intramuscular tramadol 50 mg when pain score is higher than 4) in postoperative period.

Treatment:

Procedure: Spinal Anesthesia

Device: 25G Quincke needle

Drug: Bupivacaine %0.5 (hyperbaric)

Drug: Tramadol

Drug: Acetaminophen

TAP Block with bupivacaine

Experimental group

Description:

In addition to standard perioperative care (spinal anesthesia and parenteral pain regimen) patients will receive transversus abdominis plane block (with 20ml of %0.25 isobaric bupivacaine) just before surgery is initiated.

Treatment:

Drug: Bupivacaine %0.25 (isobaric)

Procedure: Spinal Anesthesia

Device: 25G Quincke needle

Drug: Bupivacaine %0.5 (hyperbaric)

Drug: Tramadol

Procedure: Transversus Abdominis Plane Block

Drug: Acetaminophen

Device: Echogenic Needle with 30° bevel

IlNB with bupivacaine

Experimental group

Description:

In addition to standard perioperative care (spinal anesthesia and parenteral pain regimen) patients will receive Ilioinguinal nerve block (with 20ml of %0.25 isobaric bupivacaine) just before surgery is initiated.

Treatment:

Drug: Bupivacaine %0.25 (isobaric)

Procedure: Spinal Anesthesia

Procedure: Ilioinguinal Nerve Block

Device: 25G Quincke needle

Drug: Bupivacaine %0.5 (hyperbaric)

Drug: Tramadol

Drug: Acetaminophen

Device: Echogenic Needle with 30° bevel