An interventional study of Lateral Quadratus Lumborum Block and Transversalis Fascia Plane Block in İnguinal Hernia and Post Operative Pain, sponsored by Medipol University. Not yet recruiting at 1 site in Turkey (Türkiye). Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2026-05-22.
Sponsored by Medipol University · Not applicable, Interventional, and Treatment
This randomized controlled trial aims to compare the effects of ultrasound-guided lateral Quadratus Lumborum Block (QLB) and Transversalis Fascia Plane (TFP) block on postoperative analgesia in patients undergoing laparoscopic inguinal hernia repair. Ninety patients will be randomly assigned to one of three groups: Group QLB, Group TFP, or Group Control. The primary objective is to compare postoperative pain scores (NRS) at various time points within the first 24 hours. Secondary objectives include evaluating the need for rescue analgesia, total tramadol consumption, and the incidence of opioid-related side effects.
Laparoscopic inguinal hernia repair is a standard, minimally invasive procedure. However, moderate pain is common in the first 24 hours postoperatively, originating from somatic pain at trocar sites and visceral pain from peritoneal irritation and mesh placement. Multimodal analgesia, including fascial plane blocks, is recommended to reduce opioid consumption and improve pain control.
In this prospective, randomized, controlled, single-center trial, 90 patients (ASA I-III, aged 18-65) scheduled for elective laparoscopic inguinal hernia repair under general anesthesia will be allocated into three parallel arms (n=30 each) via computer-based randomization.
Group QLB: Will receive bilateral ultrasound-guided lateral Quadratus Lumborum Block (total 40 mL 0.25% bupivacaine) prior to extubation, along with 10 mL 0.25% bupivacaine infiltration at port sites.
Group TFP: Will receive bilateral ultrasound-guided Transversalis Fascia Plane Block (total 40 mL 0.25% bupivacaine) prior to extubation, along with 10 mL 0.25% bupivacaine infiltration at port sites.
Group Control: Will receive only port site infiltration (total 20 mL 0.25% bupivacaine).
All procedures will be performed aseptically by the same surgical and anesthesia team. Postoperatively, all patients will receive 1 g intravenous paracetamol every 8 hours. Postoperative pain will be assessed using the Numeric Rating Scale (NRS) by an anesthesiologist blinded to the group allocation. Intravenous tramadol (100 mg) will be administered as rescue analgesia if the NRS score is ≥ 4. Total 24-hour tramadol consumption, along with block-related complications and opioid-related side effects (nausea, vomiting, sedation), will be recorded.
549 studies on the registry are indexed under Hernia, Inguinal; 74 are open to participants now.
This study's planned enrollment of 90 is close to the median of 90 across 406 interventional studies indexed under Hernia, Inguinal.
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Exclusion Criteria:
Patients will receive bilateral lateral Quadratus Lumborum Block (QLB) and port site infiltration at the end of the surgery.
Procedure: Lateral Quadratus Lumborum Block
Patients will receive bilateral Transversalis Fascia Plane (TFP) block and port site infiltration at the end of the surgery.
Procedure: Transversalis Fascia Plane Block
Patients will receive only port site infiltration at the end of the surgery.
Procedure: Port Site Infiltration
Bilateral ultrasound-guided lateral QLB with 20 mL of 0.25% bupivacaine per side (total 40 mL). Plus, 10 mL of 0.25% bupivacaine infiltration at trocar insertion sites.
Bilateral ultrasound-guided TFP block with 20 mL of 0.25% bupivacaine per side (total 40 mL). Plus, 10 mL of 0.25% bupivacaine infiltration at trocar insertion sites.
Local infiltration of 20 mL of 0.25% bupivacaine at the trocar insertion sites.
Numeric Rating Scale (NRS) Pain Score
Postoperative pain intensity assessed using the Numeric Rating Scale (NRS). The scale ranges from 0 to 10, where 0 indicates "no pain" and 10 indicates "worst imaginable pain". Higher scores represent worse pain outcomes.
Time frame: At 0, 3, 6, 12, 18, and 24 hours postoperatively.
Total Tramadol Consumption
The cumulative dose of intravenous tramadol (in milligrams) administered as rescue analgesia.
Time frame: During the first 24 hours postoperatively.
Need for Rescue Analgesia
The number of patients requiring rescue analgesia (tramadol 100 mg IV) when the NRS score is ≥ 4.
Time frame: During the first 24 hours postoperatively
Incidence of Opioid-Related Side Effects
The number of patients experiencing postoperative nausea, vomiting, or sedation.
Time frame: During the first 24 hours postoperatively.
Incidence of Block-Related Complications
The number of patients experiencing complications related to the regional block application, such as hematoma, infection, or local anesthetic systemic toxicity (LAST).
Time frame: During the first 24 hours postoperatively.
Plan to share: No
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