title: Ultrasound-guided ilioinguinal and iliohypogastric nerve block, a comparison with the conventional technique: An observational study.
abstract: BACKGROUND
  The conventional technique of ilioinguinal and iliohypogastric nerve block may be associated with drug toxicity, block failure and needs large drug volume. The ultrasound-guided (USG) nerve block enables accurate needle positioning that may reduce the chances of drug toxicity, drug dose and block failure.
  
  
  OBJECTIVE
  In this study, we compared the onset and duration of the motor and sensory nerve block, the drug volume required and time to rescue analgesic between USG and conventional technique.
  
  
  METHODS
  Sixty male patients aged between 18 and 60 years, belonging to American society of Anesthesiology I-II, scheduled for inguinal hernia repair were enrolled in this prospective study and were randomly allocated into two groups of thirty each by computerized method.
  
  
  METHODS
  Group A patients received hernia block by 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.
  
  
  METHODS
  The data were analyzed using two independent sample t-tests for demographic and hemodynamic parameters. Nonparametric test (Mann-Whitney U-test) was used to find the significance between visual analog scale.
  
  
  RESULTS
  There was 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.
authors.affiliation: Department of Anaesthesiology, B. J. Medical College, Pune, Maharashtra, India.
authors.forename: Sunita Milind
authors.initials: SM
authors.lastname: Khedkar
authors.affiliation: Department of Anaesthesiology, B. J. Medical College, Pune, Maharashtra, India.
authors.forename: Pradnya Milind
authors.initials: PM
authors.lastname: Bhalerao
authors.affiliation: Department of Anaesthesiology, B. J. Medical College, Pune, Maharashtra, India.
authors.forename: Shweta Rahul
authors.initials: SR
authors.lastname: Yemul-Golhar
authors.affiliation: Department of Anaesthesiology, B. J. Medical College, Pune, Maharashtra, India.
authors.forename: Kalpana Vinod
authors.initials: KV
authors.lastname: Kelkar
keywords: Iliohypogastric; ilioinguinal; nerve block; ropivacaine; ultrasonography