Comparative Efficacy of Ultrasound-Guided Transversalis Fascia Plane Block Versus Quadratus Lumborum Block for Postoperative Analgesia in Inguinal Hernia Repair.

BACKGROUND

Inguinal hernia repair uses regional anesthesia techniques such as transversalis fascia plane (TFP) and quadratus lumborum (QL) blocks for targeted pain relief and reduced opioid use, offering promising alternatives to traditional methods.

Objective

This study aims to compare the efficacy of ultrasound-guided TFP block and QL block for postoperative analgesia in patients undergoing unilateral inguinal hernia repair.

METHODS

A prospective randomized double-blinded study was conducted at Vinayaka Missions Kirupananda Variyar Medical College and Hospitals, involving 60 adult patients (aged 18-80 years) undergoing elective unilateral hernioplasty. Patients were randomly allocated into two groups: TFP and QL. The primary outcome measure was the time to first rescue analgesia post-block, with secondary outcomes including total analgesic consumption and visual analog scale scores. Statistical analysis was performed using appropriate methods, with a P value < 0.05 considered significant.

RESULTS

The baseline demographic characteristics, including age, gender, comorbidities, and ASA scores, were similar between the two groups. Both groups had comparable postoperative pain scores at 30 minutes (QL: 4.14 ± 0.53, TF: 4.10 ± 0.72), and no significant difference was found in the time to first rescue analgesia. The QL block showed superior analgesic efficacy with reduced opioid consumption, while the TFP block had a significantly shorter block performance time (P = 0.028). Minor complications, such as transient hypotension, were observed but not statistically significant.

CONCLUSION

Both TFP and QL blocks offer postoperative analgesia for unilateral inguinal hernia repair, with QL block showing superior efficacy with prolonged sensory blockade and reduced consumption.