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ORIGINAL ARTICLE
Year : 2017  |  Volume : 4  |  Issue : 1  |  Page : 29-34

Ultrasound-guided ilioinguinal, iliohypogastric, and genitofemoral nerve block versus spinal subarachnoid blockade for inguinal hernia repair


1 Department of Anaesthesia and Surgical Intensive Care, Faculty of Medicine, Alexandria University, Alexandria, Egypt
2 Department of Anaesthesia, Medical Research Institute, Alexandria University, Alexandria, Egypt

Correspondence Address:
Maha Mahmoud Soliman Yakout
165 El Horrya Road, El Hadara 21648
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2356-9115.202693

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Introduction All anesthetic methods have been used for inguinal hernia repair surgeries. The use of local anesthesia (LA) techniques such as the ilioinguinal iliohypogastric nerve block (IHNB) may be the most convenient method for patients who are unfit for general anesthesia or spinal anesthesia (SA). The use of ultrasound (US)-guided techniques increases the success rate of the IHNB. The use of intravenous sedation increases the acceptability of LA techniques. Aim The aim of this study was to evaluate the effectiveness, safety, and complications of US-guided IHNB and genital branch of genitofemoral nerve (GF) block in comparison with SA for inguinal hernia repair surgeries. Patients and methods The current study was carried out on 42 patients of American Stroke Association classes I and II. Patients with recurrent, bilateral, irreducible, or large scrotal hernias were excluded. The patients were randomly divided into two equal groups using the closed envelope method, groups 1 and 2. Group 1 included 21 patients who were anesthetized using US-guided IHNB with 25 ml of 0.5% isobaric bupivacaine and genital branch of GF nerve block with 10 ml of 0.5% isobaric bupivacaine. Group 2 included 21 patients who received SA using 3 ml of 0.5% hyperbaric bupivacaine and 25 μg fentanyl. All patients received sedation as continuous propofol infusion. The propofol infusion dose was titrated until the sedation score was 4 using Ramsay Sedation Score. Result Patients receiving IHNB had better hemodynamic stability when compared with the SA group. The total postoperative analgesia was significantly lower and the first dose of postoperative analgesia was significantly delayed in the IHNB group. Postoperative ambulation was significantly early in the IHNB group. Conclusion US-guided IHNB and genital branch of GF nerve block under sedation are good anesthetic techniques for inguinal hernia repair surgeries.


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