This double-blind randomized controlled trial aimes to compares two ultrasound-guided regional techniques-lateral quadratus lumborum block versus combined ilio-inguinal/ilio-hypogastric/genitofemoral (II-IH-GFN) block-for postoperative analgesia after elective unilateral open inguinal hernia repair under spinal anesthesia in adults.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
66
Ultrasound-guided lateral quadratus lumborum block. Local anesthetic: 30 ml of (Ropivacaine 0.2%) is injected at the appropriate fascial level.
Ultrasound-guided ilio-inguinal and ilio-hypogastric block. Local anesthesia: 20 ml of 0.2% ropivacaine for ilio-inguinal and ilio-hypogastric block + 10 ml of 0.2% ropivacaine for genitofemoral anaesthesia, total injection volume = 30 ml.
Al Azhar University
Cairo, Egypt, Egypt
Cumulative opioid consumption in the first 24 hours postoperatively
Measures the total amount of opioid analgesics (expressed as morphine milligram equivalents, MME) consumed during the first postoperative 24 hours. It reflects overall analgesic efficacy of the two block techniques.
Time frame: 24 hours after surgery.
Pain intensity (VAS pain scores at rest )
Assesses the level of postoperative pain at rest using the Visual Analogue Scale (VAS), where 0 = no pain and 10 = worst imaginable pain.
Time frame: 24 hours postoperatively.
Pain intensity (VAS pain scores at movement)
Assesses the level of postoperative pain during movement using the Visual Analogue Scale (VAS), where 0 = no pain and 10 = worst imaginable pain.
Time frame: 24 hours postoperatively.
Time to first analgesic request
Determines the duration of effective analgesia provided by each block, defined as the interval from completion of the block to the first patient request for additional analgesia.
Time frame: 24 hours.
Proportion of patients requiring rescue opioid analgesia
Percentage of patients who required additional opioid analgesics beyond the planned postoperative regimen, indicating inadequate analgesia from the primary block.
Time frame: 24 hours.
Incidence of postoperative block-related complications
Evaluates safety of the blocks by recording complications such as hematoma, local anesthetic toxicity, or impaired mobility.
Time frame: 24 hours.
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Patient satisfaction score
Patient satisfaction with postoperative pain control will be evaluated using a 5-point Likert scale, allowing a simple yet reliable measure of the patient's overall analgesic experience. Each participant will rate their satisfaction as follows: 1 for "very dissatisfied," indicating poor pain relief and marked discomfort; 2 for "dissatisfied," reflecting inadequate but tolerable pain control; 3 for "neutral," representing acceptable analgesia without a clear sense of satisfaction; 4 for "satisfied," denoting good pain relief and minimal discomfort; and 5 for "very satisfied," corresponding to excellent pain control and full contentment with the postoperative analgesia regimen.
Time frame: Assessed at 24 hours postoperatively.
Post-anesthesia care unit (PACU) stay duration
Measures the time spent in the PACU
Time frame: 24 hours
Total hospital stay duration
Measures total length of hospital stay.
Time frame: 24 hours