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The aim of our study is to investigate the effect of the ultrasound guided transversalis fascia plane block on the postoperative opioid consumption as a part of multimodal analgesia in patients undergoing inguinal herniorrhaphy under spinal anesthesia.
The aim of our study is to investigate the efficacy of the ultrasound-guided transversalis fascia plane block as a postoperative analgesia as a part of multimodal analgesia in patients undergoing inguinal herniorrhaphy under spinal anesthesia.
The ultrasound (US)-guided transversalis fascia plane (TFP) block was first described by Hebbard in 2009. A local anesthetic (LA) injected between the transversus abdominis muscle, and its deep investing fascia will block the anterior and the lateral branches of the T12 and L1 nerves (4). The efficacy of this block has been demonstrated in iliac crest bone graft harvesting, caesarean section and inguinal herniorrhaphy
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| bupivacaine group | Active Comparator | the patient in this arm will receive 20 ml of 0.25% bupivacaine injection by ultrasound guided transversalis fascia block for inguinal herniorraphy |
|
| 20 ml of 0.9% normal saline solution | Placebo Comparator | he patient in this arm will receive 20 ml of 0.9% normal saline solution by ultrasound guided transversalis fascia block for inguinal herniorraphy |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| bupivacaine injection by ultrasound guided transversalis fascia plane block | Drug | With patients in a sitting position and after appropriate skin asepsis, a 25-G pencil-point spinal needle (Pencil Point Spinal Needle Set, Egemen International Ltd., Izmir, Turkey) will be inserted through the L3 to L4 or L4 to L5 intervertebral space and 15 mg of 0.5% hyperbaric bupivacaine (AstraZeneca Pharmaceuticals, Cambridge, United Kingdom) will be injected. Subsequently, the patients will be positioned supine. |
| Measure | Description | Time Frame |
|---|---|---|
| The total amount of postoperative morphine consumption during the first 24hrs postoperative. | The patients will be evaluated regarding the first demand to rescue analgesia postoperatively. The pain will be assessed by the VAS score. It will be performed in the immediate post-operative period every 15 min for the first 60 min, 2 h, 4 h, 8h, 12h, 18 and 24 h. Breakthrough pain will be defined as VAS >4 at rest. | First 24 hours postoperative |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Rabab Sabry, MD | Contact | 01010792931 | rababsabry@hotmail.com | |
| Omnia Kamel, MD | Contact | 01270 130326 | omniayehiakamel90@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Marwa Zayed, Assistant professor | Cairo University | Study Director |
| Belal Khater, Master | Cairo University | Principal Investigator |
| Mohamed Mohamed, MD |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of Medicine, Cairo University | Recruiting | Cairo | Giza Governorate | 11111 | Egypt |
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| Cairo University |
| Study Director |