QIPB in Inguinal Hernia

Официальное название

Effect of the Quadro-Iliac Plane Block on Quality of Recovery Following Laparoscopic Inguinal Hernia Surgery: A Prospective, Randomized, Controlled, Double-Blind, Multicenter Study

Обзор

Inguinal hernia repair is one of the most commonly performed surgical procedures. It is generally performed under regional anesthesia techniques, such as local anesthesia, peripheral nerve blocks, or neuraxial anesthesia (spinal or epidural anesthesia), or under general anesthesia. Despite various available analgesic regimens, numerous studies have demonstrated that postoperative pain control remains inadequate. Opioids, nonsteroidal anti-inflammatory drugs, and analgesics are frequently used for postoperative pain management. However, these medications are associated with uncertain efficacy and undesirable side effects. Pain is a critical factor in the postoperative period, contributing to delayed ambulation and paralytic ileus, ultimately hindering early discharge.

Подробное описание

Inguinal hernia repair is one of the most commonly performed surgical procedures. It is generally performed under regional anesthesia techniques, such as local anesthesia, peripheral nerve blocks, or neuraxial anesthesia (spinal or epidural anesthesia), or under general anesthesia. Despite various available analgesic regimens, numerous studies have demonstrated that postoperative pain control remains inadequate. Opioids, nonsteroidal anti-inflammatory drugs, and analgesics are frequently used for postoperative pain management. However, these medications are associated with uncertain efficacy and undesirable side effects. Pain is a critical factor in the postoperative period, contributing to delayed ambulation and paralytic ileus, ultimately hindering early discharge. Recently, Tulgar and colleagues introduced a novel fascial plane block known as the "quadro-iliac plane block". Quadro-iliac plane block is performed within the quadro-iliac plane, located between the inner surface of the iliac crest and the posterior surface of the quadratus lumborum muscle. In their study, Tulgar et al. bilaterally injected 40 mL of methylene blue into the quadro-iliac plane. They observed widespread dye dispersion along the anterior and posterior surfaces of the quadratus lumborum muscle, transversalis fascia, ilioinguinal, iliohypogastric, subcostal, and genitofemoral nerves, as well as the lumbar plexus. Based on these findings, quadro-iliac plane block has been proposed as a potentially effective technique for managing acute or chronic pain in the lumbosacral, abdominal, and hip regions.

Вмешательства

• Другое Quadro iliac plane block
  Patients in Group Q will be placed in the lateral position. A low-frequency convex transducer and a 100-mm block needle will be used. Following sterilization, the transducer will be placed parasagittally at the distal attachment of the quadratus lumborum muscle to the iliac crest. The iliac crest and quadratus lumborum muscle will be visualized, with the erector spinae muscle above and the psoas major muscle below. Using an in-plane technique, the needle will be directed toward the iliac crest.
• Другое Control group
  All patients will receive IV paracetamol (1 g, 3×1) and IV tenoxicam (20 mg, 2×1).

Первичные конечные точки

• The primary outcome is the QoR-15 score (0-150 point) at 24 hours postoperatively. [Срок оценки: 24 hours]

Критерии участия

Критерии включения

• Patients aged 18-65 years
• Undergoing elective,
• unilateral laparoscopic inguinal hernia repair
• Receiving general anesthesia

Критерии исключения

• Patients who refuse to provide consent
• Patients with contraindications to regional anesthesia
• Patients with impaired consciousness
• Patients with coagulopathy
• Patients with infections at the block site
• Emergency cases

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Тройное слепое

Основная цель

Лечение

Центры проведения

Turkey (Türkiye) · 1 центр

• Konya City Hospital — Konya

Идентификаторы

NCT: NCT06862609 · QIPB İnguinal hernia

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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