Comparison of analgesic efficacy of ultrasound guided transversalis fascia plane block and erector spinae plane block in open inguinal hernia repair - preliminary results
Hale Kefeli Çelik, Kadem Koç, Murat Ünal, Caner Genç, Serkan Tulgar
Samsun Eğitim ve Araştırma Hastanesi
Giriş: Chronic pain incidence is high in inguinal hernia surgeries. Therefore, acute and chronic pain management is particularly important. Ultrasound-guided regional anesthesia techniques performed with multimodal analgesia are important to provide adequate pain management. The aim of this study is to compare the analgesic efficacy of ultrasound-guided transversalis fascia plane block (TFPB) and low-thoracic (T12) erector spinae plane (ESP) block in patients who underwent open inguinal hernia repair. Here we present our preliminary results of 70 patients (TFPB=37 patients, ESP=33 patients).
Gereç ve Yöntem: After the ethical committee approval (2021/558), this randomized, assessor-blinded study was conducted between May 5 and September 1, 2022 (clinical trial: NCT05344105). Patients between the age of 18-65 years who underwent unilateral open inguinal hernia surgery under elective conditions were included. 24-hour tramadol consumption, pain scores, additional analgesic requirement and side effects (such as nausea and vomiting) were measured.
Bulgular: There was no significant difference between the groups in terms of age and body mass index. Cumulative tramadol consumption in the first 24 hours following surgery was lower in the TFPB group when compared to the ESPB group (101±96 mg, 154±94 mg, p = 0.02, respectively). Time to the first opioid requirement was similar between the groups (p = 0,37). There was no significant difference between the groups in terms of NRS scores, except for the 12th hour postoperatively. NRS scores with coughing were significantly lower in the TFPB group in the postoperative 12th hour (p = 0.008). Nausea occurred in one patient in the ESP group. We did not encounter any block-related complications.
Tartışma ve Sonuç: In patients undergoing open inguinal hernia repair, TFPB and ESP blocks had similar analgesic effects in terms of NRS scores assessed at rest and cough. However, TFPB significantly reduced opioid consumption in the first 24 hours postoperatively compared to ESP block.
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