Laparoscopically guided ilioinguinal nerve block for groin hernia repair.
BACKGROUND
Percutaneous ilioinguinal nerve block may reduce postoperative pain after open groin hernia repair but may be complicated by transient femoral nerve palsy in some patients. The technique of laparoscopically guided ilioinguinal nerve block is reported, and its benefits assessed in patients undergoing laparoscopic total extraperitoneal groin hernia repair.


METHODS
In this prospective study, patients who had laparoscopically guided ilioinguinal nerve block during groin hernia repair were assessed in the post-anaesthetic recovery room and the day surgery ward. Need for opiate analgesia in the recovery room and the day surgery ward was recorded. Verbal pain scores (on a scale of 0 to 3) on rest and leg movement were noted.


RESULTS
Thirty-two consecutive men and one woman, mean age 49 years (range, 29-76 years), had laparoscopic total extraperitoneal repair of groin hernia with ilioinguinal nerve block. Postoperatively, 18% of the patients required opiate analgesia in the recovery room and none in the day surgery ward. Median verbal pain scores at rest and movement were 0 (range, 0-2) and 1 (range, 0-3), respectively. No patient developed transient femoral nerve block.


CONCLUSIONS
Laparoscopically guided ilioinguinal nerve block may be applied safely and with improved postoperative comfort after groin hernia repair.
Kumar
Sudhir
S
Department of Surgery, The Royal Infirmary, Edinburgh, Scotland, United Kingdom. sudhir.kumar@luht.scot.nhs.uk
D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007264:Inguinal Canal / Q000294:innervation*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D016896:Treatment Outcome
D000701:Analgesics, Opioid