Comparison of Postoperative Analgesic Efficacy of Ultrasonographic Bilateral TAP (Transversus Abdominis Plane) Block and Anesthetic Infiltration Into Preperitoneal and the Surgical Field in Laparoscopic Unilateral TEP (Total Extraperitoneal) Herniorraphy

Status: Recruiting

Location: See location...

Intervention Type: Procedure

Study Type: Interventional

Study Phase: Not Applicable

SUMMARY

Laparoscopic inguinal hernia repair is a common surgical procedure, but postoperative pain management remains a challenge. This prospective, randomized study aims to compare the analgesic efficacy of preperitoneal and surgical site anesthetic infiltration with ultrasound-guided bilateral transversus abdominis plane (TAP) block in patients undergoing laparoscopic unilateral total extraperitoneal (TEP) herniorrhaphy. Sixty patients will be randomly allocated into two groups: Group-I will receive preperitoneal and surgical site infiltration with bupivacaine, while Group-II will receive ultrasound-guided bilateral TAP block with bupivacaine. The primary outcomes will be postoperative pain scores assessed using the visual analog scale (VAS) and additional analgesic requirements. Secondary outcomes will include postoperative hospital stay duration and cost-effectiveness. Demographic data, ASA scores, comorbidities, and operation times will be recorded. Postoperative pain will be managed with a multimodal approach, including paracetamol and NSAIDs. Rescue analgesia will be provided with intravenous paracetamol. Statistical analysis will be performed using t-tests, ANOVA, Wilcoxon-Mann-Whitney tests, and chi-square tests, as appropriate. This study aims to determine the optimal and most beneficial method for postoperative pain management and patient comfort following laparoscopic inguinal hernia repair.

Eligibility

Participation Requirements

Sex: All

Minimum Age: 18

Maximum Age: 65

Healthy Volunteers: t

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• Consenting patients,

• She will undergo laparoscopic hernia repair surgery,

• ASA-I-II,

• Between the ages of 18 and 65,

• No history of anticoagulant or antiaggregant drug use,

• Regional anesthesia is not contraindicated and the anesthesiologist deems -appropriate for regional anesthesia,

• Under general anesthesia and will undergo laparoscopic surgery,

• Fully oriented and cooperative,

• Unilateral inguinal hernia,

• No previous surgery for inguinal hernia,

• No incision in the lower abdomen,

• Not using alcohol and drugs,

• No preoperative pain and

• Patients without symptoms of strangulated hernia will be included in the study.

Locations

Other Locations

Turkey

Başakşehir Çam ve Sakura Şehir Hastanesi

RECRUITING

Başakşehir

Contact Information

Primary

Ali Bekraki, Principal Investigator

abekraki@hotmail.com

+905372437699

Backup

Yunus Fırat Emekli, Research Assistant

y.firatemekli@gmail.com

+905074920925

Time Frame

Start Date: 2025-09-04

Estimated Completion Date: 2026-06-30

Participants

Target number of participants: 60

Treatments

Active_comparator: Surgery Block

After obtaining informed consent from the volunteer patients before surgery, the patients will be taken to the operating room, monitored and put to sleep with the general anesthesia procedure that we routinely apply in laparoscopic surgeries. In laparoscopic hernia repairs, patients will be placed in supine position, after appropriate aseptic conditions are provided (the surgical area will be wiped with 10% povidone iodine so that there is no dry area and covered with sterile green drapes). Under general anesthesia, a 1 cm incision will be made 1 cm inferior to the umbilical border, a 10 mm trocar will be inserted into the preperitoneal space and blunt dissection will be performed with a 30 degree camera. After observing the preperitoneal space, two 5 mm working trocars will be placed in the midline 2 cm and 6 cm inferior to the symphysis pubis. The cord structures and Cooper ligament will be exposed and the hernia sac will be freed from the anatomical structures of the cord. Prolene

Active_comparator: TAP Block

Group-II patients will undergo bilateral TAP block under ultrasound guidance by the anesthesiologist before the patient wakes up after the operation is completed and the skin is sutured. During the block, a Hitachi brand linear USG probe will be sterilized and placed between the iliac wing and costae parallel to the costal margin in the mid-axillary line. Anatomically, skin, subcutaneous tissue, external oblique muscle, internal oblique muscle and transversus abdominis muscle will be visualized. Under USG guidance, a 21G 80 or 100 mm block needle will be advanced from medial to lateral (or lateral to medial) to reach the fascial plane between the internal oblique and transversus abdominis muscles. After confirming the block site by injecting 1-2 ml of 0.09% NaCl after negative aspiration, 15-20 ml (40-50 mg in each quadrant of the abdomen since the block will be performed bilaterally) of bupivacaine 0.5% concentration will be given to the patients in a controlled manner by negative as

Related Therapeutic Areas

Hernia

Acute Pain

Endoscopy

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Comparison of Postoperative Analgesic Efficacy of Ultrasonographic Bilateral TAP (Transversus Abdominis Plane) Block and Anesthetic Infiltration Into Preperitoneal and the Surgical Field in Laparoscopic Unilateral TEP (Total Extraperitoneal) Herniorraphy

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