[Iliohypogastric/ilioinguinal nerve block in inguinal hernia repair for postoperative pain management: comparison of the anatomical landmark and ultrasound guided techniques].

Abstract

OBJECTIVES:

The purpose of this study is to compare the efficacy of iliohypogastric/ilioinguinal nerve blocks performed with the ultrasound guided and the anatomical landmark techniques for postoperative pain management in cases of adult inguinal herniorrhaphy.

METHODS:

40 patients, ASA I-II status were randomized into two groups equally: in Group AN (anatomical landmark technique) and in Group ultrasound (ultrasound guided technique), iliohypogastric/ilioinguinal nerve block was performed with 20ml of 0.5% levobupivacaine prior to surgery with the specified techniques. Pain score in postoperative assessment, first mobilization time, duration of hospital stay, score of postoperative analgesia satisfaction, opioid induced side effects and complications related to block were assessed for 24h postoperatively.

RESULTS:

VAS scores at rest in the recovery room and all the clinical follow-up points were found significantly less in Group ultrasound (p<0.01 or p<0.001). VAS scores at movement in the recovery room and all the clinical follow-up points were found significantly less in Group ultrasound (p<0.001 in all time points). While duration of hospital stay and the first mobilization time were being found significantly shorter, analgesia satisfaction scores were found significantly higher in ultrasound Group (p<0.05, p<0.001, p<0.001 respectively).

CONCLUSION:

According to our study, US guided iliohypogastric/ilioinguinal nerve block in adult inguinal herniorrhaphies provides a more effective analgesia and higher satisfaction of analgesia than iliohypogastric/ilioinguinal nerve block with the anatomical landmark technique. Moreover, it may be suggested that the observation of anatomical structures with the US may increase the success of the block, and minimize the block-related complications.

• Authors: Abdurrahman Demirci, Esra Mercanoglu Efe, Gürkan Türker, Alp Gurbet, Fatma Nur Kaya, Ali Anil, Ilker Cimen
• Journal: Revista brasileira de anestesiologia (Rev Bras Anestesiol) 2014 Sep-Oct Vol. 64 Issue 5 Pg. 350-6 ISSN: 1806-907X [Electronic] Brazil
• Vernacular Title: Bloqueio dos nervos ílio-hipogástrico/ilioinguinal em correção de hérnia inguinal para tratamento da dor no pós-operatório: comparação entre a técnica de marcos anatômicos e a guiada por ultrassom.
• PMID: 25168440 (Publication Type: English Abstract, Journal Article)
• Copyright: Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.