Comparison of Efficacy of Transversus Abdominis Plane Block and Ilioinguinal Nerve Block for Postoperative Pain Management in Patients Undergoing Inguinal Herniorraphy With Spinal Anesthesia
Overview
- Phase
- N/A
- Intervention
- Spinal Anesthesia
- Conditions
- Pain, Postoperative
- Sponsor
- Bozyaka Training and Research Hospital
- Enrollment
- 90
- Locations
- 1
- Primary Endpoint
- Pain Assessment with Verbal Descriptor Scale (VDS)
- Status
- Completed
- Last Updated
- 10 years ago
Overview
Brief Summary
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.
Investigators
Eligibility Criteria
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
Arms & Interventions
Intrathecal bupivacaine&analgesics
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.
Intervention: Spinal Anesthesia
Intrathecal bupivacaine&analgesics
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.
Intervention: Bupivacaine %0.5 (hyperbaric)
Intrathecal bupivacaine&analgesics
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.
Intervention: 25G Quincke needle
Intrathecal bupivacaine&analgesics
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.
Intervention: Acetaminophen
Intrathecal bupivacaine&analgesics
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.
Intervention: Tramadol
TAP Block with bupivacaine
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.
Intervention: Spinal Anesthesia
TAP Block with bupivacaine
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.
Intervention: Transversus Abdominis Plane Block
TAP Block with bupivacaine
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.
Intervention: Bupivacaine %0.5 (hyperbaric)
TAP Block with bupivacaine
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.
Intervention: Bupivacaine %0.25 (isobaric)
TAP Block with bupivacaine
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.
Intervention: 25G Quincke needle
TAP Block with bupivacaine
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.
Intervention: Echogenic Needle with 30° bevel
TAP Block with bupivacaine
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.
Intervention: Acetaminophen
TAP Block with bupivacaine
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.
Intervention: Tramadol
IlNB with bupivacaine
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.
Intervention: Spinal Anesthesia
IlNB with bupivacaine
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.
Intervention: Ilioinguinal Nerve Block
IlNB with bupivacaine
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.
Intervention: Bupivacaine %0.5 (hyperbaric)
IlNB with bupivacaine
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.
Intervention: Bupivacaine %0.25 (isobaric)
IlNB with bupivacaine
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.
Intervention: 25G Quincke needle
IlNB with bupivacaine
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.
Intervention: Echogenic Needle with 30° bevel
IlNB with bupivacaine
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.
Intervention: Acetaminophen
IlNB with bupivacaine
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.
Intervention: Tramadol
Outcomes
Primary Outcomes
Pain Assessment with Verbal Descriptor Scale (VDS)
Time Frame: 1st month after surgery
Secondary Outcomes
- First pain perception in postoperative period (The time when the patients experience pain perception after surgery for the first time)(whenever in 48 hours after surgery)
- Additional analgesic requirements(1st month after surgery)
- Complications (Assessment for existence of complications related to procedures in form of Y/N (such as hypotension, bradycardia, arrythmia, hematoma, failed block, nausea, vomiting, urinary retention, headache, back pain))(1st month after surgery)