Comparison Of Postoperative Analgesic Efficacy Between Surgical Wound Site Infiltration and Ultrasound Guided Ilioinguinal Iliohypogastric Nerve Block Following Inguinal Hernia Repair Under Spinal Anaesthesia

Background: Ultrasound guided ilioinguinal iliohypogastric nerve block has been reported to provide effective analgesia after lower abdominal surgeries but there are only very few data comparing it with surgical wound site infiltration with local anaesthesia in patients undergoing inguinal hernia repair under spinal anaesthesia

Objectives: to compare the efficacy of Ultrasound guided ilioinguinal nerve block with surgical wound site infiltration for postoperative analgesia in inguinal hernia repair under spinal anaesthesia

Method: prospective cohort study comprising of 50 patients undergoing inguinal hernia repair under spinal anaesthesia and has received ultrasound guided nerve block or surgical wound site infiltration with 10 ml of 0.25% bupivacaine.Quality of analgesia was compared in terms of Visual analogue scores (VAS) at 0,0.5,1,2,4,6,12,24 hours post operatively, morphine (rescue analgesic) consumption in first 24 hrs and time to first dose of morphine. other study parameters were nausea, vomiting,sedation score measured using 4 point categorical scale and consumption of ondansetron ( rescue antiemetic).

Results: VAS scores were significantly lower in the nerve block group (p value <0.05).The morphine consumption was also significantly lower (p value<0.013) and the time to first dose of morphine was significantly longer (p value<0.0001) in the nerve block group.There was no significant difference in case of sedation nausea and vomiting and as a result the mean rescue antiemetic doses were comparable in both the groups.

Conclusion: ultrasound guided ilioinguinal iliohypogastric nerve block provided better postoperative pain control than surgical wound site infiltration for inguinal hernia repair and therefore can be recommended as a part of multimodal analgesic regimen for the same