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Abstract
Background and Aims Early postoperative ambulation and reduction of hospital stay necessitate efficient postoperative analgesia. Transversalis fascia plane block (TFPB) has been described to provide adequate postoperative analgesia after abdominal surgery. This randomized comparative trial was designed to compare the duration of analgesia provided by two different TFPB approaches; the TFPB and intramuscular QLB + TFPB in patients undergoing surgical repair of unilateral inguinal hernia.
Methods 27 patients, aged from 12 to 18 years, ASA physical status I or II, scheduled for unilateral inguinal hernia repair were enrolled. At the end of the surgical procedure and before recovery from general anesthesia, Patients were randomly assigned into two groups to receive either TFPB (Group TFPB) (figure 1) or intramuscular QLB+TFPB (Group Q+TFPB) (figure 2) using 10 ml 0.25% bupivacaine. Duration of analgesia, postoperative VAS and postoperative opioid consumption were recorded.
TFPB standard approaches.
Q+TFPB approaches.
Results Duration of block was significantly longer in Q+TFPB group when compared to TFPB group (22.1 + 3.4 h versus 11.8 + 4.8 respectively) with P value of < 0.001. A statistically significant lower VAS score was recorded in Q+TFPB group immediately and 12 h postoperative. Q+TFPB group showed a statistically significant delayed time of first analgesic request and less postoperative morphine consumption with P value of < 0.001 and 0.001 respectively.
Conclusions Ultrasound guided postsurgical intramuscular QLB+TFPB using 10 ml 0.25% bupivacaine produces more postoperative analgesic effect and less postoperative opioid consumption when compared to intramuscular TFPB in patients underwent unilateral inguinal hernia repair under general anesthesia.