THE EFFICACY OF ULTRASOUND GUIDED ILIOINGUINAL (II) AND ILIOHYPOGASTRIC (IH) NERVE BLOCK IN PROVIDING EFFECTIVE INTRAOPERATIVE ANALGESIA FOR ELECTIVE UNILATERAL INGUINAL HERNIA REPAIR IN ADULTS

Abstract

Background: Inguinal hernia is one of the common surgical procedures and the most used anaesthetic technique is neuraxial anaesthesia particularly spinal anaesthesia. We studied the efficacy of ultrasound guided ilioinguinal (II) and iliohypogastric (IH) nerve block in providing effective intraoperative anaesthesia analgesia for unilateral inguinal hernia repair in adults as an alternative to spinal anaesthesia when it is contraindicated.

Material and methods: This is a prospective observational study conducted from June 2017 to Dec 2019 at a tertiary teaching hospital in South India. A total of 100 adult patients were included in the study. All patients were administered ultrasound guided II and IH nerve block for unilateral inguinal hernia repair. Sensory block was used assessing cold alcohol skin prep and pin prick method.

Results: Among 110 patients administered ultrasound guided II and IH nerve block, surgery was successfully completed in 100 patients and 10 patients required general anaesthesia to complete the procedure. Preoperative baseline and intraoperative heart rate (HR) and mean blood pressure (MAP) variations were within 20%.

A paired t test was used to find the significance between baseline preoperative and mean of maximum recorded intra operative HR and MAP. HR and MAP variations were 10.86% and 7.08% respectively. Although the test was statistically significant (p<0.001), It was not clinically significant as variations in intraoperative HR and MAP were well within 20% of preoperative values.

Conclusion: Ultrasound guided ilioinguinal (II) and iliohypogastric (IH) nerve block provided excellent intraoperative analgesia and anaesthesia. There were less incidence of post operative complications, post operative pain, requirement of post operative analgesics and more patient satisfaction.