Analgesic Efficacy of Quadratus Lumborum vs. Transversalis Fascia Block in Inguinal Hernia Surgery

NCT06664177 | Recruiting

• 1 other identifier: GaziosmanpasaTREH-FT-İH
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

It is planned to compare the postoperative analgesic efficacy of the Transversalis Fascia Plane Block and the anterior Quadratus Lumborum Block in elective inguinal hernia surgeries.

Conditions

Pain, Postoperative

Keywords

quadratus lumborum block; Transversalis Fascia Plane Block; inguinal hernia

Outcome Measures

Primary Outcomes (1)

• time to first rescue analgesic requirement.

  Our primary aim is to compare and evaluate the time to first rescue analgesic requirement after the application of anterior Quadratus Lumborum Block and Transversalis Fascia Plane Block in patients undergoing elective inguinal hernia surgeries under spinal anesthesia.

  24 hour

Secondary Outcomes (2)

• Total Opioid Consumption

  24 hour

• To compare the NRS (Numering rating scale) values (resting and dynamic) at 2. 4. 8. 12 . 24. hours in the postoperative follow-up of the patients

  24 hour

Study Arms (2)

anterior quadratus lumborum block

ACTIVE COMPARATOR

The anterior QLB block will be applied on the operative side

Procedure: Anterior Quadratus Lumborum Block (QLB)

transversalis fascia group

ACTIVE COMPARATOR

the Transversalis Fascia Block will be applied on the operative side

Procedure: Transversalis Fascia Plane Block

Interventions

Transversalis Fascia Plane Block PROCEDURE

In the Transversalis Fascia Block group, the same procedure will be followed as in the Quadratus Lumborum block group, with the ultrasound probe being placed in the same location, and the same in-plane technique will be applied using a 22G, 100 mm peripheral block needle. The needle tip will be advanced through the posterior aponeurotic extension (tail) of the transversus abdominis muscle to the transversalis fascia plane, immediately superficial to the perinephric fat. After hydrodissection confirms correct needle placement, 20 mL of 0.25% bupivacaine will be injected slowly.

transversalis fascia group

Anterior Quadratus Lumborum Block (QLB) PROCEDURE

In the Quadratus Lumborum block group, in the lateral decubitus position, a convex ultrasound probe will be sterilely placed in the subcostal area and above the iliac crest. The quadratus lumborum and psoas major muscles, as well as the L4 vertebra's transverse process, will be visualized. Using the in-plane technique and a 22G 100 mm peripheral block needle, the placement will first be identified through hydrodissection in the subfascial area between the quadratus lumborum and psoas major muscles. After localization, 20 mL of 0.25% bupivacaine will be injected slowly, aspirating every 5 cc, while visualizing the local anesthetic pushing the fascia in the ultrasound image.

anterior quadratus lumborum block

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Ages 18-65
• ASA Classification 1-2

You may not qualify if:

• Allergy to local anesthetics
• Presence of infection at the procedure site
• BMI \> 35 kg/m²
• Bleeding disorders or anticoagulant use
• Chronic analgesic or opioid use
• Mental or psychiatric disorders
• ASA Classification 3-4 patients(Severe COPD, history of cerebrovascular events, liver and kidney disease will be excluded from the study.)

Sponsors & Collaborators

• Gaziosmanpasa Research and Education Hospital: lead

Study Sites (1)

Gaziosmanpasa Research and Training Hospital

Istanbul, 34255, Turkey (Türkiye)

RECRUITING

Related Publications (3)

• Abdelbaser I, Mageed NA, El-Emam EM, ALseoudy MM, Elmorsy MM. Preemptive analgesic efficacy of ultrasound-guided transversalis fascia plane block in children undergoing inguinal herniorrhaphy: a randomized, double-blind, controlled study. Korean J Anesthesiol. 2021 Aug;74(4):325-332. doi: 10.4097/kja.20601. Epub 2020 Dec 14.

  PMID: 33307633 RESULT

• Samerchua A, Leurcharusmee P, Panichpichate K, Bunchungmongkol N, Wanvoharn M, Tepmalai K, Khorana J, Chantakhow S. A Prospective, randomized comparative study between ultrasound-guided posterior quadratus lumborum block and ultrasound-guided ilioinguinal/iliohypogastric nerve block for pediatric inguinal herniotomy. Paediatr Anaesth. 2020 Apr;30(4):498-505. doi: 10.1111/pan.13837. Epub 2020 Feb 21.

  PMID: 32030845 RESULT

• Ahmed A, Fawzy M, Nasr MAR, Hussam AM, Fouad E, Aboeldahb H, Saad D, Osman S, Fahmy RS, Farid M, Waheb MM. Ultrasound-guided quadratus lumborum block for postoperative pain control in patients undergoing unilateral inguinal hernia repair, a comparative study between two approaches. BMC Anesthesiol. 2019 Oct 17;19(1):184. doi: 10.1186/s12871-019-0862-z.

  PMID: 31623572 RESULT

MeSH Terms

Conditions

Pain, Postoperative; Hernia, Inguinal

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms; Hernia, Abdominal; Hernia; Pathological Conditions, Anatomical

Study Officials

• Serpil Sehirlioglu, MD

  Gaziosmanpasa Research and Education Hospital

  PRINCIPAL INVESTIGATOR

Central Study Contacts

serpil Sehirlioglu, MD

CONTACT

+905054431852; drserpilsahin@gmail.com

DÖNDÜ GENÇ MORALAR, MD

CONTACT

+905053737913; dondugencm@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: SUPPORTIVE CARE
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: principal invertigator

Study Record Dates

• First Submitted: October 27, 2024
• First Posted: October 29, 2024
• Study Start: November 1, 2024
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): September 10, 2026
• Last Updated: July 7, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR
• Time Frame: always
• Access Criteria: drserpilsahin@gmail.com

Locations

TU (1)