The aim of this study is to evaluate peri-operative analgesia efficacy of ultrasound guided transversalis fascia plane block in cancer patients undergoing inguinal lymph node dissection
American Society of Anesthesiologists (ASA) class I and II.
Age ≥ 18 and ≤ 65 Years.
Cancer patients for inguinal lymph node dissection.
Body mass index (BMI): > 20 kg/m2 and < 40 kg/m2.
Patient refusal.
Local infection at the puncture site.
Coagulopathies with platelet count below 50,000 or an INR>1.6.
Unstable cardiovascular disease.
Parallel
Saline 0.9%
DrugPatients will receive a sham block was performed using an equivalent volume of normal saline 0.9%.
Transversalis fascia plane block
DrugPatients will receive ultrasound guided transversalis fascia plane block.
Degree of pain
Each patient will be instructed about postoperative pain assessment with the numeric rating scale (NRS) score. NRS (0 represents "no pain" while 10 represents "the worst pain imaginable").
Total fentanyl consumption
When elevation of Heart rate (HR) or mean arterial blood pressure (MAP) ≥ 20% of the baseline will be treated by fentanyl 0.5 μg / kg.
Total opioid consumption
The patients will be observed in the postoperative care unit for 2 h, and rescue analgesia will be provided in the form of intravenous morphine 3 mg with maximum dose of 0.1 mg/kg/dose (max 0.3 mg/kg/day) boluses if the pain score \>3. The total amount of morphine given in 24 h will be recorded for every patient.
Mean arterial pressure
Mean arterial pressure will be recorded before injection of the local anesthetics to be defined as a baseline reading and after injection then will be recorded immediately before and after surgical incision, at 30 min intervals intraoperatively, and immediately postoperative and at 2, 4, 6, 12 and 24 h postoperatively.
Heart rate
Heart rate will be recorded before injection of the local anesthetics to be defined as a baseline reading and after injection then will be recorded immediately before and after surgical incision, at 30 min intervals intraoperatively, and immediately postoperative and at 2, 4, 6, 12 and 24 h postoperatively.
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