Subarachnoid Block Versus Ultrasound Guided Transversalis Fascia Plane Block for Postoperative Analgesia of Inguinal Hernia Repair in Adults: A Randomized, Double Blinded, Controlled Trial
Overview
- Phase
- Not Applicable
- Intervention
- bupivacaine injection by ultrasound guided transversalis fascia plane block
- Conditions
- Postoperative Analgesia of Inguinal Hernia Repair in Adults
- Sponsor
- Cairo University
- Enrollment
- 80
- Locations
- 1
- Primary Endpoint
- The total amount of postoperative morphine consumption during the first 24hrs postoperative.
- Status
- Recruiting
- Last Updated
- 2 years ago
Overview
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
Investigators
Rabab
lecture of anathesia
Cairo University
Eligibility Criteria
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.
- •Platelet count \< 80000 per microliter of blood.
- •Patients known to be allergic to amide local anesthetics.
- •BMI greater than 35 kgm_
- •Opioid addiction.
- •Have communication problems that may hinder the assessement of pain postoperative.
Arms & Interventions
bupivacaine group
the patient in this arm will receive 20 ml of 0.25% bupivacaine injection by ultrasound guided transversalis fascia block for inguinal herniorraphy
Intervention: bupivacaine injection by ultrasound guided transversalis fascia plane block
20 ml of 0.9% normal saline solution
he patient in this arm will receive 20 ml of 0.9% normal saline solution by ultrasound guided transversalis fascia block for inguinal herniorraphy
Intervention: bupivacaine injection by ultrasound guided transversalis fascia plane block
Outcomes
Primary Outcomes
The total amount of postoperative morphine consumption during the first 24hrs postoperative.
Time Frame: 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.