Comparison of Quadro-Iliac Plane Block and Transversalis Fascia Plane Block for Open Inguinal Hernia Repair

This prospective observational cohort study aims to compare the postoperative analgesic effectiveness of the quadro-iliac plane block (QIPB) and transversalis fascia plane block (TFPB) in patients undergoing elective unilateral open inguinal hernia repair under spinal anesthesia. The choice of block technique will be determined by the attending anesthesiologist as part of routine clinical practice, independently of study participation, and no randomization or study-directed assignment will be performed. Patients receiving QIPB or TFPB will be prospectively followed as two cohorts. Postoperative pain scores at rest and during coughing will be assessed at 2, 4, 6, 12, and 24 hours. Time to first rescue analgesic requirement, rescue tramadol use, block performance time, and adverse events will also be compared between the two cohorts.

Inclusion Criteria: * Age between 18 and 75 years. * American Society of Anesthesiologists (ASA) physical status I-II. * Scheduled for elective unilateral open inguinal hernia repair. * Eligible to undergo spinal anesthesia. * Provision of written informed consent to participate in the study. Exclusion Criteria: * Refusal to participate in the study. * Contraindication to spinal anesthesia or peripheral nerve/interfascial plane block. * Coagulopathy or clinically significant bleeding disorder. * Infection at the block injection site. * Known allergy to local anesthetics or any medication used in the study. * Chronic opioid use or regular use of analgesic or anticonvulsant medications that may affect pain perception. * Communication or cognitive impairment that prevents reliable NRS assessment. * Inadequate or failed spinal anesthesia or requirement for conversion to general anesthesia.