Ultrasound-guided Ilioinguinal-Iliohypogastric nerve block in inguinal hernia repair surgery under general anesthesia: a randomized controlled study

Abstract

Objective: The aim of the current study was to evaluate the analgesic efficacy of ilioinguinal-iliohypogastric (II/IH) nerve block in inguinal hernia repair surgery under general anesthesia. Methods: This prospective, randomized, double blinded, controlled study was conducted on 70 patients undergoing inguinal hernia repair surgery. Patients were randomly allocated into 2 equal groups, Control group (general anesthesia group) and study group (II/IH group): general anesthesia combined with II/IH nerve block group. The primary outcome measures were the total dose of postoperative fentanyl requirements, time to first analgesic request and the postoperative visual analogue pain score (VAS) in the first postoperative 24 hours. While the secondary outcomes were the hemodynamic parameters, and side effects. Results: The total post-operative fentanyl consumption was significantly lower in the II/IH group (78.00 ± 55.72 μg) than the control group (174.14 ± 27.32 μg). The time to the first request of analgesia was significantly longer in the II/IH (305.57 ± 12.22 min) than the control (49.29 ± 19.45min) group. VAS was significantly lower in the II/IH group at 0,2,4, 8 hours post-operative than the control group. The postoperative nausea and vomiting (PONV) were significantly higher in control group than II/IH group (31.1% versus 5.7% respectively). Conclusion: This study proved that II/IH nerve block in open unilateral inguinal hernia repair under general anesthesia is effective in providing satisfactory analgesia with prolonged time of first analgesic request, decreasing the total dose of fentanyl consumption, improving postoperative VAS values and decreasing incidence of postoperative nausea and vomiting.