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Inguinal hernia repair is one of the most commonly performed surgical procedures worldwide and presents challenges in anesthesia selection and postoperative pain management. Spinal anesthesia is frequently preferred due to its advantages, such as avoiding neuromuscular blockers and endotracheal intubation. Effective postoperative analgesia is essential for improving patient comfort and reducing opioid consumption.
The anterior iliac block, a recently described technique, has emerged as a potential alternative to conventional regional anesthesia methods, offering wider nerve coverage and possibly improved analgesia. However, evidence regarding its efficacy and safety remains limited.
This study aims to evaluate the effect of the anterior iliac block on postoperative analgesia duration and patient satisfaction in patients undergoing inguinal hernia surgery.
Inguinal hernia operations are among the most frequently performed surgical procedures worldwide each year. Inguinal hernia surgery involves certain challenges, such as the choice of anesthesia and the management of postoperative analgesia. This surgical procedure is most commonly performed under spinal anesthesia due to advantages such as avoiding paralytic agents and endotracheal intubation. Providing effective postoperative analgesia in inguinal hernia surgery is of great importance in terms of increasing patient comfort and reducing opioid use.
The anterior iliac block, defined in recent years, has been proposed as an alternative to classical regional anesthesia techniques and has attracted attention due to its coverage of a wider nerve distribution area and its potential to provide more effective analgesia. This new block technique is thought to contribute to pain control, especially in the postoperative period, thereby increasing patient satisfaction. However, studies on the effectiveness and reliability of this method are still limited in the literature, and more scientific data on the subject are needed.
The main aim of this study is to investigate the effect of the Anterior Iliac Block, to be applied in patients undergoing inguinal hernia surgery, on the duration of postoperative analgesia and its impact on patient satisfaction during this process.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Anterior Iliac Block Group | Experimental | Patients will receive spinal anesthesia combined with anterior iliac block for postoperative analgesia |
|
| Control Group | Active Comparator | Patients will receive spinal anesthesia without anterior iliac block and standard postoperative analgesia |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Anterior Iliac Block | Procedure | Patients in this group received an ultrasound-guided anterior iliac block following the completion of surgery under spinal anesthesia. The block was performed under sterile conditions with the patient in the supine position. Using a high-frequency linear ultrasound probe, the anatomical landmarks in the anterior iliac region were identified, and the relevant fascial plane was visualized. A block needle was advanced in-plane under real-time ultrasound guidance, and after negative aspiration, an appropriate volume(20 ml 0.25%) of local anesthetic was injected to ensure adequate spread within the target plane. All procedures were performed by experienced anesthesiologists. Postoperative analgesia was assessed using standardized pain scores, and additional analgesic requirements were recorded. The duration of analgesia and patient satisfaction were evaluated during the postoperative period. |
| Measure | Description | Time Frame |
|---|---|---|
| Duration of Postoperative Analgesia | Time from completion of spinal anasthesia to the first request for rescue analgesia | Up to 24 hours postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative Pain Scores | Pain intensity measured using the Numeric Rating Scale | At 3, 6, 12 and 24 hours postoperative |
| Total Oioid Consumption | Total amount of tramadol consumed within the first 24 hours after surgery |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| ABDULLAH ŞENGÜL, MD | Contact | +905077345751 | abdullahsengul342@gmail.com | |
| RAMAZAN ASLANPARÇASI, MD | Contact | +905532980247 | rmzn.aslan.2015@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| ABDULLAH ŞENGÜL, MD | Şanlıurfa Mehmet Akif İnan Training and Research Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Şanlıurfa Mehmet Akif İnan Training and Research Hospital | Sanliurfa | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 14769578 | Result | Burney RE, Prabhu MA, Greenfield ML, Shanks A, O'Reilly M. Comparison of spinal vs general anesthesia via laryngeal mask airway in inguinal hernia repair. Arch Surg. 2004 Feb;139(2):183-7. doi: 10.1001/archsurg.139.2.183. | |
| 13677240 | Result | Callesen T. Inguinal hernia repair: anaesthesia, pain and convalescence. Dan Med Bull. 2003 Aug;50(3):203-18. |
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Ethics committee approval covers only aggregate data analysis; there is no permission to share individual participant data
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| Control Group (A): | Other | Patients in this group did not receive an anterior iliac block. All patients underwent surgery under spinal anesthesia, and no additional postoperative analgesic intervention was administered routinely. Analgesic medication was provided only if required based on patient-reported pain levels. Pain scores, time to first analgesic requirement, total analgesic consumption, and patient satisfaction were assessed during the postoperative period using the same standardized methods as in the intervention group. |
|
| First 24 hours postoperative |
| Patient Satisfaction | Patient-reported satisfaction with pain management using a 5 point Likert scale | At 24 hours postoperatively |
| 39609729 | Result | Yorukoglu HU, Cesur S, Izgin Avci I, GoK A, Aksu C, Selek O, Kus A. Retrospective evaluation of postoperative analgesia efficacy of a new technique in anterior iliac crest bone graft harvesting: anterior iliac block. BMC Anesthesiol. 2024 Nov 29;24(1):443. doi: 10.1186/s12871-024-02829-7. |
| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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| ID | Term |
|---|---|
| D035061 | Control Groups |
| ID | Term |
|---|---|
| D015340 | Epidemiologic Research Design |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D012107 | Research Design |
| D008722 | Methods |
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