Background: Various analgesic modalities have been used for postoperative analgesia in patients
undergoing inguinal hernia surgery.In this randomized clinical trial, we have compared the analgesic
efficacy of transverses abdominis plane (TAP) block with that of ilioinguinal/ iliohypogastric (II-IH) nerve
block and quadrates lamborum(QL) block in patients undergoing unilateral open inguinal hernia repair.
Objectives: comparison of the efficacy of either of the three types of regional anesthetic blocks , the
ultrasound –guided TAP block , ultrasound-guided Quadratus Lamborum block and ultrasound- guided
ilioinguinal and iliohypogastric nerve block in quality and duration of postoperative pain control.
Patients and methods:This is a cross-sectional, hospital based study carried out on 90 cases undergoing
inguinal hernia repair under general anesthesia using either of the three types of block in each group; the
ultrasound–guided TAP block , ultrasound- guided ilioinguinal and iliohypogastric nerve block and
ultrasound-guided Quadratus Lamborum block nerve All cases enrolled fromgeneralsurgerydepartment and
seen at the pre operative holding area before going to the operative theatre of Qena university hospital
between August 2018 to August 2019 .
Result(s):VAS were lower in the IINB group and QLB group compared to the TAP block group both at
rest and during cough. The difference in VS score was statistically significant various times postoperative.
Time to first analgesic request was delayed in IIIH nerve block Group(7.3±1.3 ) hours than TAP block
group (5.9±1.3)hours (P value .008)and time to first analgesic request was delayed in QL block Group < br />(10.3±3.9) hours than TAP block group (5.9±1.3)hours (P value 0.001) .15 patients (50%) in TAP block
group,10 patient (33.3%) in IINB group and 4 patients (13.3%)required morphine 24 hours postoperative .
Conclusion:This study demonstrated that compared to TAP block II-IH nerve block and QL block provides
better pain control after open repair of inguinal hernia when all blocks were administered under US
guidance.