Analgesic efficacy of ilioinguinal/iliohypogastric, transversus abdominis plane, and quadratus lumborum blocks in inguinal hernia surgery: A prospective randomized controlled trial.

ObjectiveThis study compared the efficacy of ilioinguinal/iliohypogastric, transversus abdominis plane, and quadratus lumborum blocks as adjuncts to spinal anesthesia for postoperative pain management in unilateral inguinal hernia repair.MethodsThis study was a prospective, randomized, controlled, single-blind study. Eighty patients were randomized into four groups: (a) ilioinguinal/iliohypogastric block group; (b) transversus abdominis plane block group; (c) quadratus lumborum block; and (d) control group. Postoperative pain was assessed using the visual analog scale at rest and during movement over 24 h. Total tramadol consumption via patient-controlled analgesia, supplemental paracetamol use, and opioid-related adverse effects were recorded.ResultsNo statistically significant differences were found in visual analog scale scores among the groups at any time point (p > 0.05). Opioid consumption ranged from 60 to 300 mg, with a mean value of 226.79 ± 49.94 mg. There was no statistically significant difference in opioid use among the groups (p = 0.930; p > 0.05). The requirement for additional analgesics did not differ significantly among the groups (p = 0.389; p > 0.05). The overall incidence of adverse effects (postoperative nausea and vomiting, and respiratory depression) was 11.2% (n = 9). No statistically significant differences were observed in the rate of adverse effects between the groups (p = 0.069; p > 0.05).ConclusionNo statistically significant differences were observed in pain scores, opioid consumption, or adverse effects between the three block groups and the control group. There was a nonsignificant trend toward lower visual analog scale scores in the ilioinguinal/iliohypogastric group compared with the transversus abdominis plane and quadratus lumborum groups during the postoperative period. Although the total number of patients requiring additional analgesics was lower in all three block groups compared with the control group, these findings were not statistically significant.Clinical Trial NumberThis trial was retrospectively registered at clinicaltrials.gov with trial number NCT06997536.