Effect of Anterior Iliac Block on Postoperative Analgesia and Patient Satisfaction in Inguinal Hernia Repair Surgery

Overview

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.

Detailed description

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.

Interventions

• Procedure Anterior Iliac Block
  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 a
• Other Control Group (A):
  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 interventi

Primary outcome measures

• Duration of Postoperative Analgesia [Time frame: Up to 24 hours postoperative]

Secondary outcome measures (3)

• Postoperative Pain Scores [Time frame: At 3, 6, 12 and 24 hours postoperative]
• Total Oioid Consumption [Time frame: First 24 hours postoperative]
• Patient Satisfaction [Time frame: At 24 hours postoperatively]

Eligibility criteria

Inclusion criteria

• 18-65 years patient
• American Society of Anesthesiologists(ASA) I-II patient

Exclusion criteria

• Patients who declined to participate in the study
• Patients with contraindications to the anterior iliac block
• Pregnant or breastfeeding patients
• Patients classified as ASA III, IV, or V

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

Turkey (Türkiye) · 1 center

• Şanlıurfa Mehmet Akif İnan Training and Research Hospital — Sanliurfa

Publications

• 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. PMID 14769578
• Callesen T. Inguinal hernia repair: anaesthesia, pain and convalescence. Dan Med Bull. 2003 Aug;50(3):203-18. PMID 13677240
• 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. PMID 39609729

Identifiers

NCT: NCT07533383 · AIBHS2026

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗