A Comparative Study of USG Guided Versus Peripheral Nerve Stimulator guided Ilioinguinal and Iliohypogastric nerve block for Post operative Analgesia in Inguinal Hernia Surgries

Inguinal hernia repair is one of the most common surgeries performed and immediate post operative pain is an important issue associated with the surgery.  Acute pain is a reaction to tissue injury, viscera distension and disease. Despite the availability of effective analgesics, 30-70% patients suffer from post operative pain.

Immediate post operative pain can result in delay in ambulation, return of gastrointestinal motility and thus discharge from the hospital. Also some patients can land up in chronic pain.

Peripheral nerve blocks like the Ilioinguinal nerve and the Iliohypogastric nerve block are effective regional anaesthetic technique in hernia surgeries with good analgesia and minimal side effects. For inguinal hernia surgeries, the most common nerves that are involved in peripheral nerve blockade are the Ilioinguinal Nerve and the Iliohypogastric nerve.  These nerves are blocked in the plane between the Transverses Abdominis and Internal Oblique muscles.

The approach to these blocks is by landmark, peripheral nerve stimulator guided technique or by USG guided nerve blocks. The failure rate of landmark technique is 45-72%. USG guided blocks can increase the success rates due to real time visualisation of underlying structures and the needle tip. Peripheral nerve stimulators have easy accessibility, easy to use and inexpensive.