By InvitationNot Applicable

Comparison of TAP and QL Blocks for Postoperative Analgesia in Open Inguinal Hernia Repair

Turkey (Türkiye)70 participantsStarted 2025-09-29

Plain-language summary

Background Postoperative pain management after open inguinal hernia repair remains a clinical challenge despite spinal anesthesia. Ultrasound-guided fascial plane blocks, such as Transversus Abdominis Plane (TAP) block and Quadratus Lumborum Block (QLB), have been increasingly used as part of multimodal analgesia. This study aimed to compare their effects on postoperative opioid consumption. Methods After ethics committee approval, 70 patients aged 18-65 years with ASA I-II undergoing elective unilateral inguinal hernia repair were included in this prospective, randomized study. Patients were allocated into two groups: Group Q (QLB) and Group T (TAP). Blocks were performed preoperatively under ultrasound guidance using the in-plane technique with 30 mL of 0.25% bupivacaine. Block success was defined as sensory blockade at T10-L1 dermatomes at 30 minutes. All patients received spinal anesthesia at the L3-L4 level with 12.5 mg of 0.5% isobaric bupivacaine. Postoperatively, patient-controlled analgesia (PCA) with tramadol was administered for 24 hours. Pain scores were assessed using the Numeric Rating Scale (NRS) at PACU and at 1, 3, 6, 12, 18, and 24 hours. Opioid consumption was recorded at 0-1, 2-12, 12-24 hours, and cumulatively over 24 hours. Postoperative side effects were also evaluated. Results Both QLB and TAP block provided effective postoperative analgesia. There were no significant differences between the groups in terms of total 24-hour opioid consumption or NRS pain scores at measured time points. However, QLB demonstrated a trend toward prolonged analgesic duration and wider dermatomal spread. Conclusion Both TAP and QLB are effective adjuncts to spinal anesthesia for postoperative analgesia in unilateral inguinal hernia repair. While QLB may offer broader and longer-lasting analgesia, its superiority over TAP block in reducing opioid consumption was not statistically significant.

Who can participate

Age range18 Years – 65 Years

SexALL

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Inclusion Criteria: * Will undergo Open Inguinal Hernia Repair * The American Society of Anesthesiologists (ASA) physical classification is 1-2. * The volunteer has read and accepted the consent form * Body mass index (BMI) \<35 Exclusion Criteria: * Body mass index (BMI) \>35 kg/m² * American Society of Anesthesiologists (ASA) physical status III-V * Inability to assess pain using the Numeric Rating Scale (NRS) * Known allergy to the local anesthetic or the planned analgesic agent * Self-reported pregnancy or breastfeeding * Age \<18 or \>65 years * Uncontrolled anxiety * Alcohol or substance abuse * Neuromuscular disease or peripheral neuropathy * Use of high-dose opioid medication within three days prior to surgery widespread chronic pain * Diabetes mellitus * Hepatic or renal insufficiency * Coagulation disorders * Current use of anticoagulant therapy * Infection at the site of peripheral block needle insertion * Ireducible, incarcerated, strangulated, or recurrent inguinal hernia * Inability to communicate in Turkish * Technical problems during the use of the patient-controlled analgesia (PCA) device * NRS score persistently above 7 for four consecutive hours despite the planned multimodal analgesia regimen * Inability to understand or use the Verbal Rating Scale for pain assessment and the Quality of Recovery-15 (QoR-15) questionnaire * Termination of surgery before completion for any reason.

What they're measuring

Postoperative Pain Examination with Numeric Rating Scale

Timeframe: 24 hours

Trial details

NCT IDNCT07527065

SponsorHitit University

Sponsor typeOTHER

Study typeINTERVENTIONAL

Primary completion2026-02-10