Inguinal Hernia Clinical Trial
Official title:
Effects of Transverse Abdominis Plane Block Guided by Ultrasound on the Postoperative Analgesia and Quality of Lives Among the Patients Undergo Inguinal Hernia Repair
The incidence of post-operative pain after open inguinal hernia repair is high and impair the quality of lives of the patients.The purpose of this study is to determine whether transverse abdominis plane block combined with intravenous patient controlled analgesia is superior to intravenous patient controlled analgesia in improving the quality of life and reducing the incidence of chronic post-surgical pain
The incidence of post-operative pain after open inguinal hernia repair is high according to
a a larger-sample epidemic research. Meanwhile, the investigators also found the incidence
of CPSP of herniorrhaphy was 37.8% among the patients with PCA, and the incidence of
neuropathic pain was 37.5% in these patients with CPSP. European hernia society has proposed
that local infiltration anesthesia was suggested to all patients without any
contraindications who undergo inguinal hernia repair. Transverse abdominis plane
block(TABP),which injecting local anesthetics into the interval between obliquus internus
abdominis muscle and transverse abdominal muscle could block the abdominal nerve and could
alleviate the pain postoperatively. TABP can block the two mainly nerve (iliohypogastric
nerve, ilioinguinal nerve) for inguinal hernia repair and so it seems to have a good effects
to relieve the pain of inguinal hernia repair. So the investigators conduct the randomized
controlled trial to investigate whether transversus abdominis plane block combined with
intravenous patient controlled analgesia is superior to intravenous patient controlled
analgesia in improving the quality of life and reducing the incidence of chronic
post-surgical pain.
This study was approved by the Medical Ethics Committee of the First Affiliated Hospital of
Chongqing Medical University. All potentially eligible participants will be asked to give
written informed consent before they are enrolled in this study. This study is a
prospective, randomized, controlled clinical trial guided by the standard of good clinical
practice (GCP), and eligible participants are divided into two groups: group TAPB and group
PCIA, and assess the outcomes of the incidence of acute and chronic postoperative pain and
the effects of the two methods on the quality of lives of patients undergo inguinal hernia
repair.
Participants in group TAPB will receive transversus abdominis plane block guided by
ultrasound at the end of the surgery and also receive intravenous patient controlled
analgesia after surgery.
Participants in group PCIA will only receive intravenous patient controlled analgesia after
surgery.
The primary outcome of the study is VAS scores at rest and in motion at 3 months
postoperatively. The secondary outcomes of this study are chronic post-surgical pain at 6
and 12 months postoperatively, acute post-operative pain, rescue medication and the
incidence of neuropathic pain at 3, 6,12 months postoperatively, also the quality of life
measured by EQ-5D questionnaire, adverse events associated with postoperative analgesia.
This study will be conducted under the supervision of an independent auditor. Every week,
the auditor checked the data of the participants the day after the surgery was conducted.
Assessment of pain intensity and prognostic outcomes must be confirmed by the auditor in
sample population. When there is disagreement between surgeon and anesthesiologists in
evaluating the prognosis of patients, the auditor must solve this disagreement by discussion
with evaluators. Data will be double-entered by two statisticians with limitation of access
and locked during statistical analysis
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment
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