This prospective observational cohort study aims to compare the postoperative analgesic effectiveness of the quadro-iliac plane block (QIPB) and transversalis fascia plane block (TFPB) in patients undergoing elective unilateral open inguinal hernia repair under spinal anesthesia. The choice of block technique will be determined by the attending anesthesiologist as part of routine clinical practice, independently of study participation, and no randomization or study-directed assignment will be performed. Patients receiving QIPB or TFPB will be prospectively followed as two cohorts. Postoperative pain scores at rest and during coughing will be assessed at 2, 4, 6, 12, and 24 hours. Time to first rescue analgesic requirement, rescue tramadol use, block performance time, and adverse events will also be compared between the two cohorts.
Age between 18 and 75 years.
American Society of Anesthesiologists (ASA) physical status I-II.
Scheduled for elective unilateral open inguinal hernia repair.
Eligible to undergo spinal anesthesia.
Refusal to participate in the study.
Contraindication to spinal anesthesia or peripheral nerve/interfascial plane block.
Coagulopathy or clinically significant bleeding disorder.
Infection at the block injection site.
Adult patients aged 18-75 years with ASA physical status I-II who are scheduled for elective unilateral open inguinal hernia repair under spinal anesthesia at Vezirköprü State Hospital and receive either QIPB or TFPB as part of routine clinical practice will be prospectively enrolled. The choice of block technique will be determined by the attending anesthesiologist independently of study participation.
Cohort
Prospective
Quadro iliac Plane Block
Procedure/SurgeryUltrasound-guided quadro-iliac plane block (QIPB) performed as part of routine clinical practice. In patients receiving QIPB, 40 mL of 0.25% bupivacaine is administered into the quadro-iliac plane.
Transversalis Fascia Plane Block
Procedure/SurgeryUltrasound-guided transversalis fascia plane block (TFPB) performed as part of routine clinical practice. In patients receiving TFPB, 30 mL of 0.25% bupivacaine is administered into the transversalis fascia plane.
Postoperative Pain Intensity at Rest
Postoperative pain intensity at rest will be assessed using the 11-point Numeric Rating Scale (NRS), ranging from 0 (no pain) to 10 (worst imaginable pain).
Postoperative Pain Intensity During Coughing
Postoperative pain intensity during coughing will be assessed using the 11-point Numeric Rating Scale (NRS), ranging from 0 (no pain) to 10 (worst imaginable pain).
Time to First Rescue Tramadol Requirement
Time from the end of surgery to the first administration of intravenous rescue tramadol (1 mg/kg) for an NRS score of 4 or higher will be recorded in minutes.
Block Performance Time
Block performance time will be defined as the time from initial contact of the ultrasound probe with the patient until completion of the local anesthetic injection and will be recorded in seconds.
Incidence of Adverse Events
The incidence of nausea, vomiting, hypotension, bradycardia, local anesthetic systemic toxicity, and other adverse events related to the block procedure will be recorded.
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