title: Improved perioperative analgesia with ultrasound-guided ilioinguinal/iliohypogastric nerve or transversus abdominis plane block for open inguinal surgery: a systematic review and meta-analysis of randomized controlled trials.
abstract: [Purpose] Ultrasound-guided ilioinguinal/iliohypogastric (II/IH) nerve and transversus abdominis plane (TAP) blocks have been increasingly utilized in patients for perioperative analgesia. We conducted this meta-analysis to evaluate the clinical efficacy of ultrasound-guided II/IH nerve or TAP blocks for perioperative analgesia in patients undergoing open inguinal surgery. [Subjects and Methods] A systematic search was conducted of 7 databases from the inception to March 5, 2015. Randomized controlled trials (RCTs) comparing the clinical efficacy of ultrasound-guided vs. landmark-based techniques to perform II/IH nerve and TAP blocks in patients with open inguinal surgery were included. We constructed random effects models to pool the standardized mean difference (SMD) for continuous outcomes and the odds ratio (OR) for dichotomized outcomes. [Results] Ultrasound-guided II/IH nerve or TAP blocks were associated with a reduced use of intraoperative additional analgesia and a significant reduction of pain scores during day-stay. The use of rescue drugs was also significantly lower in the ultrasound-guided group. [Conclusion] The use of ultrasound-guidance to perform an II/IH nerve or a TAP block was associated with improved perioperative analgesia in patients following open inguinal surgery compared to landmark-based methods.
authors.affiliation: Department of Anesthesiology Pain Division, Mayo Clinic, USA; Department of Ultrasound Medicine, Chinese PLA General Hospital, China.
authors.forename: Yuexiang
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Physical Medicine and Rehabilitation, Mayo Clinic, USA; Department of Physical Medicine and Rehabilitation, Sir Run Run Shaw Hospital, College of Medicine of Zhejiang University, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Wu
authors.affiliation: Department of Physical Medicine and Rehabilitation, Mayo Clinic, USA.
authors.forename: Marisa J
authors.initials: MJ
authors.lastname: Terry
authors.affiliation: Department of Anesthesiology Pain Division, Mayo Clinic, USA.
authors.forename: Jason S
authors.initials: JS
authors.lastname: Eldrige
authors.affiliation: Department of Anesthesiology Pain Division, Mayo Clinic, USA; Department of Physical Medicine and Rehabilitation, Mayo Clinic, USA.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Tong
authors.affiliation: Department of Library-Public Services, Mayo Clinic, USA.
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Erwin
authors.affiliation: Center for the Science of Healthcare Delivery, Mayo Clinic, USA.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology Pain Division, Mayo Clinic, USA; Department of Physical Medicine and Rehabilitation, Mayo Clinic, USA.
authors.forename: Wenchun
authors.initials: W
authors.lastname: Qu
keywords: Ilioinguinal/iliohypogastric nerve; Inguinal surgery; Ultrasound