Efficacy of Ultrasound-Guided Transversalis Fascia Plane Block (TFP) for Postoperative Analgesia in Inguinal Hernia Repair in Adults Under Spinal Anesthesia: A Randomized, Double-Blinded, Controlled Trial

Background: Inguinal herniorrhaphy is a commonly per-formed surgical procedure that is performed under spinal an-esthesia. Effective postoperative pain management is crucial for preventing complications and improving patient comfort. The use of multimodal analgesia is essential for pain manage-ment. An innovative regional analgesic treatment that covers the T12–L1 dermatomes, the transversalis fascia plane block (TFPB) is appropriate for this procedure. Additionally, it pro-vides long-lasting pain relief that goes beyond the effects of spinal anesthesia. Aim of Study: The aim of the study was to assess the effect of TFPB on the total 24-hour postoperative morphine consump-tion in patients who underwent inguinal herniorrhaphy. Patients and Methods: Eighty patients undergoing spinal anesthesia for inguinal hernia surgery were involved in this ran-domized, double-blind, controlled trial. After receiving a TFPB, each patient was allocated into one of two groups: Study group TFPB was given 20 milliliters of 0.25% bupivacaine. Twenty milliliters of saline were given to the control group. Postoper-atively, paracetamol was administered at 8-hour intervals, with morphine as rescue analgesics. Results: At rest and during coughing pain scores (VAS) at 2, 4, and 8 hours postoperatively, in group TFPB were con-siderably lower (p<0.001). TFPB group consumed significantly less opioids (8.1±4.3mg) postoperatively than Control group (16.1±3.2mg, p<0.001). The TFPB group had a significantly longer time to first rescue analgesia (p<0.001). Conclusion: The TFP block is an efficient postoperative analgesic modality for inguinal hernia repair under spinal anes- thesia, as it reduces opioid consumption, improves pain relief, and enhances patient recovery and mobility. Research and ethics committee approval number: ID: MS-48-2023. Clinical Trials registration ID: NCT06219837.