It is planned to compare the postoperative analgesic efficacy of the Transversalis Fascia Plane Block and the anterior Quadratus Lumborum Block in elective inguinal hernia surgeries.
Ages 18-65
ASA Classification 1-2
Allergy to local anesthetics
Presence of infection at the procedure site
BMI > 35 kg/m²
Bleeding disorders or anticoagulant use
Crossover
Transversalis Fascia Plane Block
Procedure/SurgeryIn the Transversalis Fascia Block group, the same procedure will be followed as in the Quadratus Lumborum block group, with the ultrasound probe being placed in the same location, and the same in-plane technique will be applied using a 22G, 100 mm peripheral block needle. The needle tip will be advanced through the posterior aponeurotic extension (tail) of the transversus abdominis muscle to the transversalis fascia plane, immediately superficial to the perinephric fat. After hydrodissection confirms correct needle placement, 20 mL of 0.25% bupivacaine will be injected slowly.
Anterior Quadratus Lumborum Block (QLB)
Procedure/SurgeryIn the Quadratus Lumborum block group, in the lateral decubitus position, a convex ultrasound probe will be sterilely placed in the subcostal area and above the iliac crest. The quadratus lumborum and psoas major muscles, as well as the L4 vertebra's transverse process, will be visualized. Using the in-plane technique and a 22G 100 mm peripheral block needle, the placement will first be identified through hydrodissection in the subfascial area between the quadratus lumborum and psoas major muscles. After localization, 20 mL of 0.25% bupivacaine will be injected slowly, aspirating every 5 cc, while visualizing the local anesthetic pushing the fascia in the ultrasound image.
time to first rescue analgesic requirement.
Our primary aim is to compare and evaluate the time to first rescue analgesic requirement after the application of anterior Quadratus Lumborum Block and Transversalis Fascia Plane Block in patients undergoing elective inguinal hernia surgeries under spinal anesthesia.
Total Opioid Consumption
To compare the total analgesic consumption in the first 24 hours postoperatively.
To compare the NRS (Numering rating scale) values (resting and dynamic) at 2. 4. 8. 12 . 24. hours in the postoperative follow-up of the patients
Assessed at various time points to quantify pain intensity at rest and during movement. The Numerical Rating Scale (NRS) is a pain assessment tool where patients rate their pain from 0 (no pain) to 10 (worst pain).
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