Ultrasound guided transversus abdominis plane block versus ilioinguinal and iliohypogastric nerve block versus local infiltration for postoperative analgesia in inguinal hernia surgery.
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Enrollment
- 90
- Locations
- 1
- Primary Endpoint
- To compare the quality of postoperative analgesia using Visual Analogue Scale
Study Overview
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
Study Design
- Study Type
- Interventional
- Allocation
- Coin toss, Lottery, toss of dice, shuffling cards etc
- Masking
- Outcome Assessor Blinded
Eligibility Criteria
- Ages
- 18.00 Year(s) to 65.00 Year(s) (—)
- Sex
- Male
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.
Outcomes
Primary Outcomes
To compare the quality of postoperative analgesia using Visual Analogue Scale
Time Frame: 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.
(VAS) of transversus abdominis plane block versus ilioinguinal and iliohypogastric
Time Frame: 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.
nerve blocks USG guided versus local infiltration.
Time Frame: 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 Outcomes
- 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,)