Laparoscopic-Assisted Psoas blockade: A novel post-operative analgesic technique in patients undergoing laparoscopic inguinal hernia repair

INTERVENTION: The Laparoscopic‐Assisted Psoas blockade was conducted after induction of general anesthesia. Under laparoscopic guidance and after achieving proper exposure of the psoas major muscle, a 5‐mm horizontal incision was made in the ventral fascia of the psoas major muscle to provide a proper access for the block catheter. Successful catheter placement was confirmed by expansion of the plane between the psoas muscle and its corresponding fascia with 2 ml normal saline injection. After negative aspiration, twenty milliliters of plain bupivicaine (2.5 mg/ml) were incrementally administered through the catheter. CONDITION: Postoperative pain in patients undergoing inguinal hernia repair PRIMARY OUTCOME: The primary outcome measure is the total morphine requirements in the first 36 hours postoperatively SECONDARY OUTCOME: All patients will be asked to rate their postoperative surgical pain at rest and while coughing by using a numerical rating scale (NRS) (NRS: 0= no pain, 10= worst pain) The dermatomal sensory involvement of both approaches will be estimated bilaterally with pinprick and thermal tests after block performance. The most proximal and distal levels of sensory involvement will be established if the same dermatome level will be recorded on three consecutive times. The time to first request for analgesia is defined as the time from completion of the block injection (taken as time zero minute) to the first postoperative administration of IV morphine. INCLUSION CRITERIA: Male patients scheduled for elective laparoscopic unilateral inguinal hernia repair with ASA physical status I–III will be enrolled in the clinical trial.