Fascia transversalis block with different volumes of local anesthetic and its impact on postoperative pain in major abdominal surgery: prospective randomized study

Eman Eltabey Lotfi Taman, Resident of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Egypt.Follow
Mostafa Mohamed Ali Saied, Professor of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Egypt.
Khaled Mohy Eldeen El Bahrawy, Professor of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Egypt.
Abdelrahman Mamdouh El Naggar, Lecturer of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Egypt.

Subject Area

Anaesthesia and Surgical Intensive Care

Article Type

Original Study

Abstract

Background Effective postoperative analgesia remains crucial in abdominal surgery to reduce physiological stress, improve respiratory function, and enhance recovery. The transversalis fascia plane block (TFPB) has recently emerged as an advantageous technique targeting the T12–L1 nerves responsible for somatic and visceral abdominal innervation. Objective To investigate the analgesic efficacy of different volumes of local anesthetic administered in TFPB and compare their effect on postoperative pain, visceral discomfort, and opioid requirements. Methods Eighty-one adult patients undergoing major abdominal surgery under general anesthesia were randomized into 3 groups: control (systemic analgesia only), lowvolume TFPB (20 mL total), and high-volume TFPB (25 mL total). primary outcome was total postoperative analgesic requirement during the 1st 24 hours . secondary outcomes included block characteristics, VAS scores, visceral pain and side effects. Results Both TFPB groups demonstrated significantly improved analgesic profiles in contrast to the control. The high-volume group showed the longest duration before first analgesic request and the lowest 24-hour analgesic consumption. At rest and after coughing, pain levels were consistently lower in the high-volume group across all postoperative time points. Visceral pain incidence was markedly reduced in both block groups compared with controls, with the high-volume block providing the longest visceral painfree interval. Conclusion TFPB provides effective postoperative somatic and visceral analgesia in major abdominal surgery. Higher anesthetic volumes offer superior analgesic duration, lower overall analgesic requirements, and reduced visceral discomfort compared with lowvolume and control treatments.

Recommended Citation

Taman, Eman Eltabey Lotfi; Saied, Mostafa Mohamed Ali; Bahrawy, Khaled Mohy Eldeen El; and Naggar, Abdelrahman Mamdouh El (2026) "Fascia transversalis block with different volumes of local anesthetic and its impact on postoperative pain in major abdominal surgery: prospective randomized study," Mansoura Medical Journal: Vol. 56 : Iss. 1 , Article 12.
Available at: https://doi.org/10.58775/2735-3990.1524