Postoperative Pain Control in Inguinal Hernia Surgery: A Prospective, Randomized, Double-Blind Comparative Study of Transversus Abdominis Plane Block Versus Transversalis Fascia Block

Abstract Background and Aim: Open inguinal hernia repair is a common surgical procedure frequently associated with significant postoperative pain. Regional nerve blocks play a key role in multimodal analgesia to optimize pain control. This study primarily aimed to compare the duration of analgesia provided by the transversus abdominis plane (TAP) block and the transversalis fascia block (TFB). The secondary objective was to compare the total postoperative analgesic requirements between the two groups. Study Design: Randomized, double-blind clinical study. Materials and Methods: Forty-six patients undergoing open inguinal hernia surgery were enrolled after meeting inclusion and exclusion criteria. They were randomly allocated into two groups: Group A received a TAP block, and Group B received a TFB block at the end of surgery. Each block was performed using 20 mL of 0.25% bupivacaine with adrenaline (5 µg/mL). Postoperative pain was assessed using the visual analog scale at 4-h intervals over 24 h. The time to first rescue analgesic and total 24-h analgesic consumption were recorded. Statistical analysis was performed using Statistical Package for the Social Sciences version 28 and G*Power 3.1.9.4 software. Results: The mean time to first rescue analgesic was 10.9 ± 5.64 h in Group A and 14.2 ± 5.04 h in Group B, showing a statistically significant difference ( P = 0.019). The total 24-h analgesic requirement was significantly lower in Group B compared to Group A (1.0 vs. 1.52 doses, P = 0.006). Conclusion: TFB provided a longer duration of analgesia and reduced postoperative analgesic requirements compared to the TAP block in patients undergoing open inguinal hernia surgery, making it a more effective option for postoperative pain management.