EP099 Comparison of postoperative analgesic efficacy of anterior and posterior quadratus lumborum and paravertebral blocks in elective inguinal hernia surgeries under spinal anesthesia: a prospective randomised controlled trial

<h3>Background and Aims</h3> Pain after inguinal hernia surgery is a major reason for delayed discharge. To minimize opioid-related side effects, regional techniques like quadratus lumborum (QL) and paravertebral (PVB) blocks are increasingly used. This study aims to compare the postoperative analgesic effectiveness of abterior and posterior QL , and PVB blocks in patients undergoing elective inguinal hernia repair under spinal anesthesia. <h3>Methods</h3> Following ethical approval and informed consent, the study was conducted at Gaziosmanpaşa Training and Research Hospital. Patients who underwent inguinal hernia surgery under spinal anesthesia were randomly assigned to receive either anterior and posterior QL, or PVB block postoperatively. Data collected included demographics, 24-hour total analgesic consumption, NRS (Numeric rating Scale) scores, time to first analgesic use, and side effects like nausea or vomiting. <h3>Results</h3> 124 patients were included (mean age 51.2 years; 91.1% male). Demographics were similar across groups. Analgesic requirement within 24 hours was highest in the control group, lower in QL groups, and lowest in the PVB group. Although early NRS scores (1–12 hrs) did not differ significantly, 24-hour resting NRS scores were significantly lower in all block groups. First rescue analgesia was required later in the anterior QL and PVB groups. <h3>Conclusions</h3> Truncal blocks such as QL and PVB effectively reduce postoperative pain after spinal anesthesia in inguinal hernia surgeries. They may support earlier mobilization and reduce the risk of chronic postoperative pain.