Comparative Evaluation of Efficacy of Ultrasound-guided Ilioinguinal and Iliohypogasrtic Block with Conventional Technique Using PNS in Inguinal Hernia Repair

Abstract

Introduction: The traditional method of blocking the ilioinguinal and iliohypogastric nerves may result in drug toxicity, block failure, and a significant amount of medication. Accurate needle placement made possible by the ultrasound-guided nerve block may lower the risk of medication toxicity, overdosage, and block failure. Aim: In this study, we examined the time to rescue analgesia, drug volume needed, and onset and duration of the motor and sensory nerve block between USG and conventional methods. Settings and Design: In this prospective study, 60 male patients with inguinal hernias between the ages of 18 and 60 who were the American Society of Anesthesiology I-II members and scheduled for repair were included in the study. They were randomly divided into two groups of 30 patients each using a computerized approach. Materials and Methods: Group A patients received hernia block by the conventional method using 0.75% ropivacaine 15 ml, and Group B patients were given the block guided by ultrasound using 0.75% ropivacaine, till the nerves were surrounded on all sides by the drug. Statistical Analysis: The data were analyzed using two independent sample t-tests for demographic and hemodynamic parameters. A nonparametric test (Mann–Whitney U-test) was used to find the significance between the Visual Analog Scale. Results: There was a significantly early onset of sensory block in Group B 14.03 ± 2.82 min as compared to Group A 15.57 ± 1.52 min ( P = 0.047). The onset of motor block was also earlier in Group B 19.40 ± 2.85 min as compared to Group A 20.67 ± 1.90 min. The time to rescue analgesia was more in Group B 7.22 ± 0.97 h as compared to Group A 6.80 ± 0.70 h ( P = 0.062). The volume of drug required was less with ultrasound-guided block. Conclusions: Ultrasound-guided hernia block thus has the advantage of early onset, less dose requirement, and increase in time to rescue analgesia.