Quadro-Iliac Plane Block for Postoperative Analgesia in Laparoscopic Inguinal Hernia Repair

The goal of this randomized controlled trial is to learn whether an ultrasound-guided quadro-iliac plane block (QIPB) reduces opioid use and pain after laparoscopic inguinal hernia repair in adults aged 18-65 years. The main question it aims to answer is: does QIPB reduce total tramadol consumption during the first 24 postoperative hours? Researchers will compare patients who receive QIPB under general anesthesia with patients who receive no block. All participants will receive the same general anesthesia, multimodal analgesia and intravenous tramadol patient-controlled analgesia (PCA). Pain scores, PCA use, quality of recovery (QoR-15), nausea and vomiting, and time to discharge will be recorded during the first 24 hours.

Inclusion Criteria: * Age 18-65 years * American Society of Anesthesiologists (ASA) physical status I-III * Scheduled for elective unilateral laparoscopic inguinal hernia repair (TAPP or TEP) under general anesthesia * Written informed consent Exclusion Criteria: * Refusal to participate * Bilateral hernia repair or conversion to open surgery * Known allergy to local anesthetics or study drugs * Coagulopathy or ongoing therapeutic anticoagulation * Infection at the block site * Chronic pain or regular opioid use before surgery * Severe hepatic or renal dysfunction * Pregnancy * Inability to understand the NRS or use the PCA device