A randomised study of ilio-inguinal nerve blocks following inguinal hernia repair: a stopped randomised controlled trial.
BACKGROUND
Local anaesthetic use for post-operative pain control is widely used following open inguinal hernia repair but this is not without risk. The aim of this study was to compare ilio-inguinal nerve block and wound irrigation in patients undergoing open inguinal hernia repair under general anaesthetic in a randomised, double blind, placebo controlled trial.


METHODS
Adult patients admitted for unilateral primary open mesh repair of an inguinal hernia were recruited. The patients received a standard general anaesthetic. Prior to skin incision, an ilio-inguinal injection was performed by the anaesthetist with either ropivicaine or normal saline. Prior to closure of the wound, the wound was irrigated with either ropivicaine or normal saline. Post-operatively, all patients received fentynal patient controlled analgesia and regular oral analgesia. Pain scores and visual analogue scores were recorded until discharge. Patients were then contacted by telephone at 24h, 48h, 2weeks and 4weeks post-operatively and asked a standard series of questions, mainly related to post-operative pain.


RESULTS
After 12 patients had been recruited the trial was stopped as 5 of the 8 patients who received an ilio-inguinal nerve block suffered a neurological complication.


CONCLUSIONS
Ilio-inguinal nerve block with ropivicaine should be avoided.
Walker
Stuart
S
Royal Hobart Hospital, Liverpool Street, Hobart, Tasmania, Australia. stuart.walker@dhhs.tas.gov.au
Orlikowski
Chris
C
D000328:Adult; D000577:Amides; D000779:Anesthetics, Local; D004311:Double-Blind Method; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007085:Ilium / Q000294:innervation; D007264:Inguinal Canal / Q000294:innervation; D009407:Nerve Block / Q000009:adverse effects*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D000077212:Ropivacaine; D007507:Therapeutic Irrigation
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine