NCT06997536

Comparison of Postoperative Analgesic Efficacy of Ultrasound-Guided Ilioinguinal-Iliohypogastric Block, Transversus Abdominis Plane Block, and Quadratus Lumborum Block in Inguinal Hernia Surgery

Completed NA Last updated 30 May 2025

What this trial tests

NA trial testing Ilioinguinal/iliohypogastric Nerve Block in Inguinal Hernia in 80 participants. Completed in 1 May 2024.

Timeline

28 June 2022

Primary endpoint
28 June 2023

1 May 2024

Quick facts

Lead sponsor	Namik Kemal University
Phase	NA
Status	Completed
Study type	INTERVENTIONAL
Allocation	randomized
Design	factorial
Masking	single
Primary purpose	diagnostic
Enrollment	80
Start date	28 June 2022
Primary completion	28 June 2023
Estimated completion	1 May 2024
Sites	1 location across Turkey (Türkiye)

Drugs / interventions tested

• Ilioinguinal/iliohypogastric Nerve Block — full drug profile →
• Transversus abdominis plane (TAP) block — full drug profile →
• Quadratus Lumborum Block (QLB) — full drug profile →

Conditions studied

• Inguinal Hernia — all drugs for Inguinal Hernia →
• Transversus Abdominis Plane (TAP) Block — all drugs for Transversus Abdominis Plane (TAP) Block →
• Iliohypogastric/Ilioinguinal Nerve Block — all drugs for Iliohypogastric/Ilioinguinal Nerve Block →
• Quadratus Lumborum Block — all drugs for Quadratus Lumborum Block →

Sponsor

Namik Kemal University

Who can join

Adults 18 to 75, any sex, with Inguinal Hernia or Transversus Abdominis Plane (TAP) Block. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

Inguinal hernia is a common condition, particularly among male patients, and represents one of the most frequent indications for lower abdominal surgeries. Postoperative acute pain and, more importantly, the progression of acute pain into chronic pain, remain significant challenges in the postoperative period. Effective postoperative pain management is therefore crucial in inguinal hernia repair.

In addition to systemic analgesia, various regional anesthesia techniques are employed in this setting. In recent years, peripheral nerve blocks such as the ilioinguinal-iliohypogastric (IL/IH) block, transversus abdominis plane (TAP) block, and quadratus lumborum block (QLB) have gained popularity for postoperative analgesia. These techniques offer several advantages, including reduced opioid consumption and decreased need for additional analgesics, while also minimizing hemodynamic instability and facilitating early mobilization.

The IL/IH block is performed by injecting a local anesthetic into the fascial plane between the transversus abdominis and internal oblique muscles, targeting the ilioinguinal and iliohypogastric nerves, which are branches of the L1 spinal nerve. The TAP block, first described by Rafi in 2001, involves injecting local anesthetic into the fascial plane between the internal oblique and transversus abdominis muscles within the Petit triangle, where the T6-T11 spinal nerve branches responsible for abdominal wall innervation are located. The quadratus lumborum block (QLB) was initially described by Blanco. The first version, known as QLB1, involves posterior injection of local anesthetic lateral to the quadratus lumborum muscle. In 2013, Jens Børglum introduced the transmuscular variant (QLB3), where the local anesthetic is administered between the quadratus lumborum and psoas muscles.

In this study, we aimed to compare postoperative outcomes in patients undergoing inguinal hernia repair under spinal anesthesia, with and without additional peripheral nerve blocks (IL/IH block, TAP block, and QLB). Specifically, we evaluated pain levels using the Visual Analog Scale (VAS) at the 30th minute, 2nd, 6th, 12th, and 24th hours postoperatively. We also assessed opioid-related side effects such as nausea and vomiting associated with patient-controlled analgesia (PCA) using tramadol, the total bolus and infusion doses of tramadol administered, and the amount of additional analgesia in the form of paracetamol. These outcomes were compared among the different block groups and with a control group that received only spinal anesthesia without any additional block.

Publications & conference data

No peer-reviewed publications indexed yet for this trial. Completed trials usually publish results within 12-18 months.