Ultrasound-guided ilioinguinal/iliohypogastric nerve block compared to posterior quadratus lumborum block in patients undergoing inguinal hernia repair

Abstract

ABSTRACTBackground “Ilioinguinal/iliohypogastric nerve block” (IINB) has been described as effective regional anesthetic method for providing analgesia after inguinal hernia operations. Other studies have also reported that the “posterior quadratus lumborum block” (PQLB) is an effective analgesic option for lower abdominal surgeries. Herein, we compared the previous two block techniques for postoperative pain management in adults undergoing unilateral inguinal hernia repair.Methods According to the block technique, 76 adult patients scheduled for inguinal hernioplasty under general anesthesia were randomly enrolled into two groups; the PQLB and IINB groups. The block was performed after skin closure and before patient extubation. Postoperative analgesic profiles were recorded in both groups.Results The PQLB had lower heart rate and mean arterial pressure readings during postoperative assessment compared to the other group. Pain scores showed a significant decline in association with the PQLB during the first postoperative day, which resulted in a significant decline in pethidine consumption (49.17 vs. 70 mg in the IINB group) and better patient satisfaction. The duration to the first analgesic request significantly increased in association with the PQLB (13.25 vs. 8.42 hours in the IINB group). The incidence of nausea and vomiting increased significantly in the IINB group secondary to increased pethidine requirements.Conclusion PQLB is superior to IINB in providing analgesia for patients undergoing inguinal hernia repair.

Keywords

• Inguinal hernia
• quadratus lumborum block
• ilioinguinal/Iliohypogastric nerve block