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Comparison between different nerve blocks for postoperative pain in inguinal hernia surgery.

Completed
Conditions
Bilateral inguinal hernia, withoutobstruction or gangrene, (2) ICD-10 Condition: O||Medical and Surgical,
Registration Number
CTRI/2021/09/036895
Lead Sponsor
Teerthanker Mahaveer Medical College and Research Centre
Brief Summary

Patients undergoing inguinal hernia repair experience severe pain in postoperative period

especially during first 24hrs. Many approaches or multi modal techniques can be used to

minimize pain. One such method is to supplement iv analgesics with nerve blocks or local

infiltration.



Nerve blocks will provide analgesia and also lessen the requirement of I v. analgesics in

terms of doses and frequency of administration, thereby minimizing side effects of the

latter.



**Aim**: To compare the effectiveness of USG guided transversus abdominis

plane(TAP) block versus USG guided ilioinguinal and iliohypogastric nerve blocks

versus local infiltration in herniorrhaphy for postoperative analgesia.



**Objectives:**



To assess the duration of post operative analgesia in USG guided transversus

abdominis plane block.



To assess the duration of post operative analgesia in USG guided ilioinguinal and

iliohypogastric nerve block.



To assess the duration of post operative analgesia with wound infiltration at

proposed site of incision.



To compare the quality of postoperative analgesia using Visual Analogue Scale

(VAS) of transversus abdominis plane block versus ilioinguinal and iliohypogastric

nerve blocks USG guided versus local infiltration.

**METHODOLOGY**

Each patient will be explained the entire procedure and purpose in his/her

language. Written informed consent for the procedure will be taken.



The subarachnoid block will be administered in sitting position with 25G Quincke

needle at either L2-L3 or L3-L4 space.



Randmonisation by chit and box method.

Group T: Transverse abdominis plane block using 20ml of 0.25% bupivacaine with

5mcg/ml adrenaline OR



Group I: Ilioinguinal/iliohypogastric nerve Block -10ml 0.25% Bupivacaine in

ilioinguinal and10ml 0.25% Bupivacaine in iliohypogastric with 5mcg/ml adrenaline.

Total volume 20ml OR



Group L: Infiltration of incision site with 20ml of 0.25% bupivacaine with 5mcg/ml

adrenaline



VAS scores will be assessed at 0, 15mins, 30mins, 1, 2, 4, 6, 10, 14, 18, and 24

hours, where the time 0 at the start of the surgery.



Hemodynamics will be assessed intraoperatively at 0min, 1min, 5, 10, 15, 20,

30, 40, 50, 60, 75, 90, 120mins.



Postperatively patient will be given Inj. PCM 1mg IV infusion as first rescue

analgesia and then it will be continued 8 hourly.



After collection of the data, appropriate statistical test will be applied and

conclusion will be drawn

Detailed Description

Not available

Recruitment & Eligibility

Status
Completed
Sex
Male
Target Recruitment
90
Inclusion Criteria

American society of Anaesthesiology physical status I and II Surgery lasting for< 2hr Patient with BMI 18.5-22.9kg/m2.

Exclusion Criteria
  • Patients who refused to consent to the study.
  • Skin infection at the puncture site.
  • Hypersensitivity to LA agents.
  • Pregnancy Preoperative opioid or non-steroidal anti-inflammatory drugs treatment for chronic pain.
  • Contraindication to subarachnoid block (SAB).
  • Patient requiring supplementary analgesics or conversion to G.A.

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
To compare the quality of postoperative analgesia using Visual Analogue ScaleVAS scores will be assessed at 0, 15mins, 30mins, 1, 2, 4, 6, 10, 14, 18, and 24 | hours, where the time 0 at the start of the surgery.
(VAS) of transversus abdominis plane block versus ilioinguinal and iliohypogastricVAS scores will be assessed at 0, 15mins, 30mins, 1, 2, 4, 6, 10, 14, 18, and 24 | hours, where the time 0 at the start of the surgery.
nerve blocks USG guided versus local infiltration.VAS scores will be assessed at 0, 15mins, 30mins, 1, 2, 4, 6, 10, 14, 18, and 24 | hours, where the time 0 at the start of the surgery.
Secondary Outcome Measures
NameTimeMethod
Hemodynamics will be assessed intraoperatively, first rescue analgesia requirement and total analgesic requirement in 24 hrs.Hemodynamics will be assessed intraoperatively at 0min, 1min, 5, 10, 15, 20,

Trial Locations

Locations (1)

Teerthanker mahaveer medical college and research centre

🇮🇳

Moradabad, UTTAR PRADESH, India

Teerthanker mahaveer medical college and research centre
🇮🇳Moradabad, UTTAR PRADESH, India
Dr Neha Kumari
Principal investigator
7906307174
nehaadhana01@gmail.com

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